Barcoding melting curve analysis for rapid, sensitive, and discriminating authentication of saffron (Crocus sativus L.) from its adulterants.

PubMed

Jiang, Chao; Cao, Liang; Yuan, Yuan; Chen, Min; Jin, Yan; Huang, Luqi

2014-01-01

Saffron (Crocus sativus L.) is one of the most important and expensive medicinal spice products in the world. Because of its high market value and premium price, saffron is often adulterated through the incorporation of other materials, such as Carthamus tinctorius L. and Calendula officinalis L. flowers, Hemerocallis L. petals, Daucus carota L. fleshy root, Curcuma longa L. rhizomes, Zea may L., and Nelumbo nucifera Gaertn. stigmas. To develop a straightforward, nonsequencing method for rapid, sensitive, and discriminating detection of these adulterants in traded saffron, we report here the application of a barcoding melting curve analysis method (Bar-MCA) that uses the universal chloroplast plant DNA barcoding region trnH-psbA to identify adulterants. When amplified at DNA concentrations and annealing temperatures optimized for the curve analysis, peaks were formed at specific locations for saffron (81.92°C) and the adulterants: D. carota (81.60°C), C. tinctorius (80.10°C), C. officinalis (79.92°C), Dendranthema morifolium (Ramat.) Tzvel. (79.62°C), N. nucifera (80.58°C), Hemerocallis fulva (L.) L. (84.78°C), and Z. mays (84.33°C). The constructed melting curves for saffron and its adulterants have significantly different peak locations or shapes. In conclusion, Bar-MCA could be a faster and more cost-effective method to authenticate saffron and detect its adulterants.

21 CFR 73.500 - Saffron.

Code of Federal Regulations, 2012 CFR

2012-04-01

... EXEMPT FROM CERTIFICATION Foods § 73.500 Saffron. (a) Identity. (1) The color additive saffron is the..., in amounts consistent with good manufacturing practice, except that it may not be used to color foods... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Saffron. 73.500 Section 73.500 Food and Drugs FOOD...

21 CFR 73.500 - Saffron.

Code of Federal Regulations, 2014 CFR

2014-04-01

... EXEMPT FROM CERTIFICATION Foods § 73.500 Saffron. (a) Identity. (1) The color additive saffron is the..., in amounts consistent with good manufacturing practice, except that it may not be used to color foods... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Saffron. 73.500 Section 73.500 Food and Drugs FOOD...

21 CFR 73.500 - Saffron.

Code of Federal Regulations, 2013 CFR

2013-04-01

... EXEMPT FROM CERTIFICATION Foods § 73.500 Saffron. (a) Identity. (1) The color additive saffron is the..., in amounts consistent with good manufacturing practice, except that it may not be used to color foods... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Saffron. 73.500 Section 73.500 Food and Drugs FOOD...

Greek PDO saffron authentication studies using species specific molecular markers.

PubMed

Bosmali, I; Ordoudi, S A; Tsimidou, M Z; Madesis, P

2017-10-01

Saffron, the spice produced from the red stigmas of the flower of Crocus sativus L. is a frequent target of fraud and mislabeling practices that cannot be fully traced using the ISO 3632 trade standard specifications and test methods. A molecular approach is proposed herein as a promising branding strategy for the authentication of highly esteemed saffron brands such as the Greek Protected Designation of Origin (PDO) "Krokos Kozanis". Specific ISSR (inter-simple sequence repeat) markers were used to assess for the first time, the within species variability of several populations of C. sativus L. from the cultivation area of "Krokos Kozanis" as well as the potential differences with the band pattern produced by other Crocus species. Then, species-specific markers were developed taking advantage of an advanced molecular technique such as the HRM analysis coupled with universal DNA barcoding regions (trnL) (Bar-HRM) and applied to saffron admixtures with some of the most common plant adulterants (Calendula officinalis, Carthamus tinctorius, Gardenia jasminoides, Zea mays and Curcuma longa). The sensitivity of the procedure was tested for turmeric as a case study whereas HPLC-fluorescence determination of secondary metabolites was also employed for comparison. The overall results indicated that the Bar-HRM approach is quite effective in terms of specificity and sensitivity. Its effectiveness regarding the detection of turmeric was comparable to that of a conventional HPLC method (0.5% vs 1.0%, w/w). Yet, the proposed DNA-based method is much faster, cost-effective and can be used even by non-geneticists, in any laboratory having access to an HRM-capable real-time PCR instrumentation. It can be, thus, regarded as a strong analytical tool in saffron authentication studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Challenges of climate change: omics-based biology of saffron plants and organic agricultural biotechnology for sustainable saffron production.

PubMed

Husaini, Amjad M

2014-01-01

Kashmir Valley is a major saffron (Crocus sativus Kashmirianus) growing area of the world, second only to Iran in terms of production. In Kashmir, saffron is grown on uplands (termed in the local language as "Karewas"), which are lacustrine deposits located at an altitude of 1585 to 1677 m above mean sea level (amsl), under temperate climatic conditions. Kashmir, despite being one of the oldest historical saffron-producing areas, faces a rapid decline of saffron industry. Among many other factors responsible for decline of saffron industry the preponderance of erratic rainfalls and drought-like situation have become major challenges imposed by climate change. Saffron has a limited coverage area as it is grown as a 'niche crop' and is a recognized "geographical indication," growing under a narrow microclimatic condition. As such it has become a victim of climate change effects, which has the potential of jeopardizing the livelihood of thousands of farmers and traders associated with it. The paper discusses the potential and actual impact of climate change process on saffron cultivation in Kashmir; and the biotechnological measures to address these issues.

Cardiovascular Effects of Saffron: An Evidence-Based Review

PubMed Central

Kamalipour, Maryam; Akhondzadeh, Shahin

2011-01-01

Herbal medicine can be a valuable source of assistance for traditional medicine. There are a number of herbs that can be used in conjunction with modern medicine. Herbs can also be taken to aid recovery from serious diseases. Although one should never aim to treat diseases such as cardiovascular disease solely with herbal medicine, the value of herbs used in tandem with modern medicine cannot be ignored. Saffron has been reported to help lower cholesterol and keep cholesterol levels healthy. Animal studies have shown saffron to lower cholesterol by as much as 50%. Saffron has antioxidant properties; it is, therefore, helpful in maintaining healthy arteries and blood vessels. Saffron is also known to have anti-inflammatory properties, which are beneficial to cardiovascular health. The people of Mediterranean countries, where saffron use is common, have lower than normal incidence of heart diseases. From saffron’s cholesterol lowering benefits to its anti inflammatory properties, saffron may be one of the best supplements for cardiac health. This paper reviews the studies regarding the beneficial effects of saffron in cardiovascular health. PMID:23074606

Contact dermatitis in saffron workers: clinical profile and identification of contact sensitizers in a saffron-cultivating area of Kashmir Valley of North India.

PubMed

Hassan, Iffat; Kamili, Afifa; Rasool, Farhan; Nehvi, Firdous; Rather, Parvaiz; Yasmin, Salwee; Pampori, Rafiq A; Jabeen, Yasmeen; Yaseen, Atiya; Bashir, Safia; Naaz, Saima

2015-01-01

Saffron, a bulbous perennial plant belonging to Iridaceae family, is the most expensive cultivated herb that is widely used for industrial and nonindustrial purposes. However, besides its attractive and valuable properties, contact dermatitis due to saffron is an uncommon reported entity. The aims of this study were to determine the clinical pattern patch-testing profile of contact dermatitis in saffron workers and to identify the most common allergens/sensitizers. One hundred ten saffron workers were patch-tested with 39 allergens, which included Indian standard series antigens, plant series antigens, and extracts from different parts of saffron flower. The allergens in Indian standard series accounted for 52.44% of positive reactions. Plant series and different parts of saffron accounted for 47.56% of the positive reactions. Among those patients with positive responses to the supplemental saffron allergens, 83.3% were of present or past relevance. The data observed in the present study confirm that the saffron dermatitis is a distinct clinical entity with characteristic clinical presentation and has a strong significance as an occupational allergen in those handling this plant. Patch testing with different parts of saffron flower has a role to play in finding out the etiological cause.

21 CFR 73.500 - Saffron.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES EXEMPT FROM CERTIFICATION Foods § 73.500 Saffron. (a) Identity. (1) The color additive saffron is the... identity as a color additive only, and shall not be construed as setting forth an official standard for...

Comparative analysis of pistil transcriptomes reveals conserved and novel genes expressed in dry, wet, and semidry stigmas.

PubMed

Allen, Alexandra M; Lexer, Christian; Hiscock, Simon J

2010-11-01

Fertilization in angiosperms depends on a complex cellular "courtship" between haploid pollen and diploid pistil. These pollen-pistil interactions are regulated by a diversity of molecules, many of which remain to be identified and characterized. Thus, it is unclear to what extent these processes are conserved among angiosperms, a fact confounded by limited sampling across taxa. Here, we report the analysis of pistil-expressed genes in Senecio squalidus (Asteraceae), a species from euasterid II, a major clade for which there are currently no data on pistil-expressed genes. Species from the Asteraceae characteristically have a "semidry stigma," intermediate between the "wet" and "dry" stigmas typical of the majority of angiosperms. Construction of pistil-enriched cDNA libraries for S. squalidus allowed us to address two hypotheses: (1) stigmas of S. squalidus will express genes common to wet and dry stigmas and genes specific to the semidry stigma characteristic of the Asteraceae; and (2) genes potentially essential for pistil function will be conserved between diverse angiosperm groups and therefore common to all currently available pistil transcriptome data sets, including S. squalidus. Our data support both these hypotheses. The S. squalidus pistil transcriptome contains novel genes and genes previously identified in pistils of species with dry stigmas and wet stigmas. Comparative analysis of the five pistil transcriptomes currently available (Oryza sativa, Crocus sativus, Arabidopsis thaliana, Nicotiana tabacum, and S. squalidus), representing four major angiosperm clades and the three stigma states, identified novel genes and conserved genes potentially regulating pollen-pistil interaction pathways common to monocots and eudicots.

Short communication: investigating the effect of saffron (Crocus sativus L.) nano-sizing on its colour extraction efficiency: a preliminary study.

PubMed

Abootalebian, Mehrdad; Karbasi, Maryam; Sadeghi, Maliheh; Abdinian, Mahnaz; Polikarpov, Igor

2017-10-01

This study investigated the effect of saffron nano-sizing on its the colour extraction yield. The whole stigma was ball-milled at three different times (10, 20 and 100 h), immediately or with a 24 h delay was submitted to absorption test, and then the colour extraction efficiency was determined. When stigma was milled for 100 h, its particle size was reduced to less than 20 nm, as shown by SEM and TEM images, and its extraction efficiency was considerably increased by 19.8% as compared with the stigma blended for 10 min. However with a 24 h delay between the end of milling and absorption test, the yield of colour extraction significantly decreased. The recommended milling conditions resulting in extraction efficiency of 16.2% (in comparison with stigma blended for 10 min) were determined to be the milling for 10 h with initial tendering prior to milling operation.

Saffron: Its Phytochemistry, Developmental Processes, and Biotechnological Prospects.

PubMed

Ahrazem, Oussama; Rubio-Moraga, Angela; Nebauer, Sergio G; Molina, Rosa Victoria; Gómez-Gómez, Lourdes

2015-10-14

The present state of knowledge concerning developmental processes and the secondary metabolism of saffron, Crocus sativus L. (Iridaceae), along with the genes involved in these processes so far known, is reviewed. Flowers and corms constitute the most valuable parts of saffron. Corm and flower development are two key aspects to be studied in saffron to increase the yield and quality of the spice, to raise its reproductive rate, and to implement new production systems. Important knowledge about the physiology of flowering and vegetative growth has been acquired in recent years, but there is still only limited information on molecular mechanisms controlling these processes. Although some genes involved in flower formation and meristem transition in other species have been isolated in saffron, the role of these genes in this species awaits further progress. Also, genes related with the synthesis pathway of abscisic acid and strigolactones, growth regulators related with bud endodormancy and apical dominance (paradormancy), have been isolated. However, the in-depth understanding of these processes as well as of corm development is far from being achieved. By contrast, saffron phytochemicals have been widely studied. The different flower tissues and the corm have been proved to be an important source of phytochemicals with pharmacological properties. The biotechnological prospects for saffron are here reviewed on the basis of the discovery of the enzymes involved in key aspects of saffron secondary metabolism, and we also analyze the possibility of transferring current knowledge about flowering and vegetative propagation in model species to the Crocus genus.

Neuroprotective Activities of Saffron and Crocin.

PubMed

Soeda, Shinji; Aritake, Kosuke; Urade, Yoshihiro; Sato, Hiroshi; Shoyama, Yukihiro

2016-01-01

We first considered that saffron is really safety food because it has a long-use history. The neuroprotective activities of saffron and its major constituent, crocin, are separately discussed in vitro and in vivo. We reviewed the inhibitory activities of crocin against PC-12 cell apoptosis. The oxidative stress decreased the cellular levels of glutathione (GSH) which is an inhibitor of neutral sphingomyelinase (N-SMase). Therefore, the level of GSH was assayed by the addition of crocin resulted in the activation of glutathione reductase (GR). It became evident that crocin treatment prevents the N-SMase activation resulting in the decrease of ceramide release. From these evidences we summarized the role of crocin for neuronal cell death. We used the ethanol-blocking assay system for learning and memory activities. The effect of saffron and crocin on improving ethanol-induced impairment of learning behaviors of mice in passive avoidance tasks has been clear. Further, we did make clear that saffron and crocin prevent the inhibitory effect of ethanol on long-term potentiation (LTP) in the dentate gyrus. Finally we found that 100 mg/kg of crocin gave non-rapid eye movement sleep (non-REM sleep) although mice were started to be active during night time.

Potential application of machine vision technology to saffron (Crocus sativus L.) quality characterization.

PubMed

Kiani, Sajad; Minaei, Saeid

2016-12-01

Saffron quality characterization is an important issue in the food industry and of interest to the consumers. This paper proposes an expert system based on the application of machine vision technology for characterization of saffron and shows how it can be employed in practical usage. There is a correlation between saffron color and its geographic location of production and some chemical attributes which could be properly used for characterization of saffron quality and freshness. This may be accomplished by employing image processing techniques coupled with multivariate data analysis for quantification of saffron properties. Expert algorithms can be made available for prediction of saffron characteristics such as color as well as for product classification. Copyright © 2016. Published by Elsevier Ltd.

Antiviral Effects of Saffron and its Major Ingredients.

PubMed

Soleymani, Sepehr; Zabihollahi, Rezvan; Shahbazi, Sepideh; Bolhassani, Azam

2018-01-01

The lack of an effective vaccine against viral infections, toxicity of the synthetic anti-viral drugs and the generation of resistant viral strains led to discover novel inhibitors. Recently, saffron and its compounds were used to treat different pathological conditions. In this study, we tested the anti-HSV-1 and anti-HIV-1 activities of Iranian saffron extract and its major ingredients including crocin and picrocrocin as well as cytotoxicity in vitro. The data showed that the aqueous saffron extract was not active against HIV-1 and HSV-1 virions at certain doses (i.e., a mild activity), but crocin and picrocrocin indicated significant anti-HSV-1 and also anti-HIV-1 activities. Crocin inhibited the HSV replication at before and after entry of virions into Vero cells. Indeed, crocin carotenoid suppressed HSV penetration in the target cells as well as disturbed virus replication after entry into the cells. Picrocrocin was also effective for inhibiting virus entry and also its replication. This monoterpen aldehyde showed higher anti-HSV effects after virus penetrating in the cells. Generally, these sugar-containing compounds extracted from saffron showed to be effective antiherpetic drug candidates. The recent study is the first report suggesting antiviral activities for saffron extract and its major ingredients. Crocin and picrocrocin could be a promising anti-HSV and anti-HIV agent for herbal therapy against viral infections. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Saffron as an antidote or a protective agent against natural or chemical toxicities.

PubMed

Razavi, Bibi Marjan; Hosseinzadeh, Hossein

2015-05-01

Saffron (Crocus sativus) is an extensively used food additive for its color and taste. Since ancient times this plant has been introduced as a marvelous medicine throughout the world. The wide spectrum of saffron pharmacological activities is related to its major constituents including crocin, crocetin and safranal. Based on several studies, saffron and its active ingredients have been used as an antioxidant, antiinflammatory and antinociceptive, antidepressant, antitussive, anticonvulsant, memory enhancer, hypotensive and anticancer. According to the literatures, saffron has remarkable therapeutic effects. The protective effects of saffron and its main constituents in different tissues including brain, heart, liver, kidney and lung have been reported against some toxic materials either natural or chemical toxins in animal studies.In this review article, we have summarized different in vitro and animal studies in scientific databases which investigate the antidotal and protective effects of saffron and its major components against natural toxins and chemical-induced toxicities. Due to the lake of human studies, further investigations are required to ascertain the efficacy of saffron as an antidote or a protective agent in human intoxication.

Efficacy of Crocus sativus (saffron) in treatment of major depressive disorder associated with post-menopausal hot flashes: a double-blind, randomized, placebo-controlled trial.

PubMed

Kashani, Ladan; Esalatmanesh, Sophia; Eftekhari, Farzaneh; Salimi, Samrand; Foroughifar, Tahereh; Etesam, Farnaz; Safiaghdam, Hamideh; Moazen-Zadeh, Ehsan; Akhondzadeh, Shahin

2018-03-01

Due to concerns regarding the side effects of hormone therapy, many studies have focused on the development of non-hormonal agents for treatment of hot flashes. The aim of this study was to evaluate the efficacy and safety of saffron (stigma of Crocus sativus) in treatment of major depressive disorder associated with post-menopausal hot flashes. Sixty women with post-menopausal hot flashes participated in this study. The patients randomly received either saffron (30 mg/day, 15 mg twice per day) or placebo for 6 weeks. The patients were assessed using the Hot Flash-Related Daily Interference Scale (HFRDIS), Hamilton Depression Rating Scale (HDRS) and the adverse event checklist at baseline and also at the second, fourth, and sixth weeks of the study. Fifty-six patients completed the trial. Baseline characteristics of the participants did not differ significantly between the two groups. General linear model repeated measures demonstrated significant effect for time × treatment interaction on the HFRDIS score [F (3, 162) = 10.41, p = 0.0001] and HDRS score [F (3, 162) = 5.48, p = 0.001]. Frequency of adverse events was not significantly different between the two groups. Results from this study revealed that saffron is a safe and effective treatment in improving hot flashes and depressive symptoms in post-menopausal healthy women. On the other hand, saffron, with fewer side effects, may provide a non-hormonal and alternative herbal medicine option in treatment of women with hot flashes.

Enhanced Bioaccessibility of Crocetin Sugar Esters from Saffron in Infusions Rich in Natural Phenolic Antioxidants.

PubMed

Ordoudi, Stella A; Kyriakoudi, Anastasia; Tsimidou, Maria Z

2015-09-25

The present study aims to examine whether and to what extent the bioaccessibility of the major saffron apocarotenoids, namely crocetin sugar esters (CRTSEs), is affected by the presence of strong water-soluble antioxidants, ingredients of the herbs found in commercial tea blends with saffron. An in vitro digestion model was applied to infusions from these products to investigate the possible changes. All of the studied infusions were rich in total phenols (9.9-22.5 mg caffeic acid equivalents/100 mg dry infusion) and presented strong DPPH radical scavenging activity regardless of the composition of the corresponding herbal blends. RP-HPLC-DAD and LC-MS analysis enabled the grouping of the infusions into hydroxycinnamic acid-rich and in flavan-3-ol-rich ones. CRTSEs in herbal tea infusions were found to be significantly more bioaccessible (66.3%-88.6%) than those in the reference saffron infusion (60.9%). The positive role of strong phenolic antioxidants (caffeic acid, rosmarinic acid) on the stability of CRTSEs was also evidenced in model binary mixtures. On the contrary, cinnamic acid, exerting no antioxidant activity, did not have such an effect. Our findings suggest that strong radical scavengers may protect the crocetin sugar esters from oxidation during digestion when present in excess.

[Studies on the pharmacological effects of saffron(Crocus sativus L.)--a review].

PubMed

Deng, Ying; Guo, Zhi-gang; Zeng, Zhao-lin; Wang, Zhao

2002-08-01

Reviewing the studies on the chemical components and medicinal value. Philological method. Saffron is a conventional effective medicine in improving blood circulation and curing the bruise. The late of evidesnces indicate that saffron possesses anticancer activity against a wide spectrum of tumors, such as leukemia, ovarian carcinoma, colon adenocarcinoma, rhabdomyosarcoma, papilloma, squamous cell carcinoma, and soft tissue sarcoma. It has low biochemical toxic effects on animals. In addition, saffron can be used to cure coronary heart disease and hepatitis, and to promote immunity. Saffron is a highly valuable medicine. And producing it in a large quantity has a wide application prosperity.

Saffron in phytotherapy: pharmacology and clinical uses.

PubMed

Schmidt, Mathias; Betti, Georges; Hensel, Andreas

2007-01-01

Saffron (stigmata of Crocus sativus L.) has been used for medicinal purposes for millennia. Throughout history, uses against cancer and depressive mood can regularly be identified. These applications have also been in the focus of modern research. Promising and selective anti-cancer effects have been observed in vitro and in vivo, but not yet in clinical trials. Antidepressant effects were found in vivo and in clinical pilot studies. Saffron extracts thus have the potential to make a major contribution to rational phytotherapy.

Razi’s Al-Hawi and saffron (Crocus sativus): a review

PubMed Central

Mollazadeh, Hamid; Emami, Seyyed Ahmad; Hosseinzadeh, Hossein

2015-01-01

Traditional knowledge can be used as a source for development of new medicines. In the present study, we compare the data on saffron in Razi’s Al-Hawi book with modern scientific studies. A computerized search of published articles was performed using MEDLINE, Scopus as well as native references. The search terms used were saffron, Crocus sativus, crocetin, crocin, safranal, Razi, and Al-Hawi. A variety of properties of saffron including diuretic, analgesic, anti-inflammatory, hepatoprotective, appetite suppressant, hypnotic, antidepressant, and bronchodilator effects were mentioned in Al-Hawi. Modern studies also confirmed most of these characteristics. This review indicates that the pharmacological data on saffron and its constituents are similar to those found in Razi’s Al-Hawi monograph and it can be concluded that ethnobotanical information and ancient sources have precious data about medicinal plants that lead to finding new compounds for treatment of several diseases. PMID:26877844

Comparison of Saffron and Fluvoxamine in the Treatment of Mild to Moderate Obsessive-Compulsive Disorder: A Double Blind Randomized Clinical Trial

PubMed Central

Esalatmanesh, Sophia; Biuseh, Mojtaba; Noorbala, Ahmad Ali; Mostafavi, Seyed-Ali; Rezaei, Farzin; Mesgarpour, Bita; Mohammadinejad, Payam; Akhondzadeh, Shahin

2017-01-01

Objective: There are different pathophysiological mechanisms for obsessive- compulsive disorder (OCD) as suggested by the serotonergic, dopaminergic, and glutamatergic hypotheses. The present study aimed at comparing the efficacy and safety of saffron (stigma of Crocus sativus) and fluvoxamine in the treatment of mild to moderate obsessive- compulsive disorder. Method: In this study, 50 males and females, aged 18 to 60 years, with mild to moderate OCD, participated. The patients were randomly assigned to receive either saffron (30 mg/day, 15 mg twice a day) or fluvoxamine (100 mg/day) for 10 weeks. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Adverse Event Checklist, we assessed the patients at baseline, and at the second, fourth, sixth, eighth, and tenth week. Finally, the data were analyzed using general linear repeated measures. Results: In this study, 46 patients completed the trial. General linear repeated measures demonstrated no significant effect for time-treatment interaction on the Y-BOCS total scores [F (2.42, 106.87) = 0.70, P = 0.52], obsession Y-BOCS subscale scores [F (2.47, 108.87) = 0.77, p = 0.49], and compulsion Y-BOCS subscale scores [F (2.18, 96.06) = 0.25, P = 0.79]. Frequency of adverse events was not significantly different between the 2 groups. Conclusion: Our findings suggest that saffron is as effective as fluvoxamine in the treatment of patients with mild to moderate OCD. PMID:29062366

Implications of Carotenoid Biosynthetic Genes in Apocarotenoid Formation during the Stigma Development of Crocus sativus and Its Closer Relatives1

PubMed Central

Castillo, Raquel; Fernández, José-Antonio; Gómez-Gómez, Lourdes

2005-01-01

Crocus sativus is a triploid sterile plant characterized by its long red stigmas, which produce and store significant quantities of the apocarotenoids crocetin and crocin, formed from the oxidative cleavage of zeaxanthin. Here, we investigate the accumulation and the molecular mechanisms that regulate the synthesis of these apocarotenoids during stigma development in C. sativus. We cloned the cDNAs for phytoene synthase, lycopene-β-cyclase, and β-ring hydroxylase from C. sativus. With the transition of yellow undeveloped to red fully developed stigmas, an accumulation of zeaxanthin was observed, accompanying the expression of CsPSY, phytoene desaturase, and CsLYCb, and the massive accumulation of CsBCH and CsZCD transcripts. We analyzed the expression of these two transcripts in relation to zeaxanthin and apocarotenoid accumulation in other Crocus species. We observed that only the relative levels of zeaxanthin in the stigma of each cultivar were correlated with the level of CsBCH transcripts. By contrast, the expression levels of CsZCD were not mirrored by changes in the apocarotenoid content, suggesting that the reaction catalyzed by the CsBCH enzyme could be the limiting step in the formation of saffron apocarotenoids in the stigma tissue. Phylogenetic analysis of the CsBCH intron sequences allowed us to determine the relationships among 19 Crocus species and to identify the closely related diploids of C. sativus. In addition, we examined the levels of the carotenoid and apocarotenoid biosynthetic genes in the triploid C. sativus and its closer relatives to determine whether the quantities of these specific mRNAs were additive or not in C. sativus. Transcript levels in saffron were clearly higher and nonadditive, suggesting that, in the triploid gene, regulatory interactions that produce novel effects on carotenoid biosynthesis genes are involved. PMID:16183835

Effect of saffron (Crocus sativus L.) enrichment on antioxidant and sensorial properties of wheat flour pasta.

PubMed

Armellini, R; Peinado, I; Pittia, P; Scampicchio, M; Heredia, A; Andres, A

2018-07-15

Saffron, used in cookery as a flavouring and colouring agent, is well-known for its antioxidant and beneficial health properties. In the present work, the effect of saffron addition (0-control, 0.1, 0.2 and 0.4%, w/w) in the formulation of fresh pasta was evaluated on textural, physical-chemical, and sensory properties of the cooked product. Content and retention of the bioactive molecules of saffron (crocins) were evaluated by HPLC along with the corresponding antioxidant activity of enriched pasta. The presence of saffron significantly influenced textural and physical-chemical properties of pasta. Higher saffron concentrations enhanced the antioxidant activity of pasta with the higher values of crocins in samples enriched with 0.4% saffron extract even after 3 min of cooking (4.23-5.06 mg/g db). Sensory analysis showed an increased acceptability of the saffron enriched pasta for all descriptors selected (visual aspect, colour, aroma, taste, chewiness, hardness, gumminess and overall acceptability). Copyright © 2018 Elsevier Ltd. All rights reserved.

Crocus sativus L. (saffron) for cancer chemoprevention: A mini review

PubMed Central

Bhandari, Prasan R.

2015-01-01

Cancer is one of the most feared diseases globally and there has been a sustained rise in its incidence in both developing and developed countries. Despite the growing therapeutic options for patients with cancer, their efficacy is time-limited and non-curative. Hence to overcome these drawbacks, an incessant screening for superior and safer drugs has been ongoing for numerous decades, resulting in the detection of anti-cancer properties of several phytochemicals. Chemoprevention using readily available natural substances from vegetables, fruits, herbs and spices is one of the significantly important approaches for cancer prevention in the present era. Among the spices, Crocus sativus L. (saffron; 番紅花 fān hóng huā) has generated interest because pharmacological experiments have established numerous beneficial properties including radical scavenging, anti-mutagenic and immuno-modulating effects. The more powerful components of saffron are crocin, crocetin and safranal. Studies in animal models and with cultured human malignant cell lines have demonstrated antitumor and cancer preventive activities of saffron and its main ingredients. This review provides a brief insight into the anticancer properties of saffron and its components. PMID:26151016

Avicenna's (Ibn Sina) the Canon of Medicine and saffron (Crocus sativus): a review.

PubMed

Hosseinzadeh, Hossein; Nassiri-Asl, Marjan

2013-04-01

In this review, we introduce the traditional uses of saffron and its pharmacological activities as described by either Avicenna in Book II, Canon of Medicine (al-Qanun fi al-tib) or from recent scientific studies. Modern pharmacological findings on saffron are compared with those mentioned in Avicenna's monograph. A computerized search of published articles was performed using MEDLINE, Scopus and Web of Science databases as well as local references. The search terms used were saffron, Crocus sativus, crocin, crocetin, safranal, picrocrocin, Avicenna and 'Ibn Sina'. Avicenna described various uses of saffron, including its use as an antidepressant, hypnotic, anti-inflammatory, hepatoprotective, bronchodilatory, aphrodisiac, inducer of labour, emmenagogue and others. Most of these effects have been studied in modern pharmacology and are well documented. The pharmacological data on saffron and its constituents, including crocin, crocetin and safranal, are similar to those found in Avicenna's monograph. This review indicates that the evaluation of plants based on ethnobotanical information and ancient books may be a valuable approach to finding new biological activities and compounds. Copyright © 2012 John Wiley & Sons, Ltd.

Evaluation of saffron (Crocus sativus L.) adulteration with plant adulterants by (1)H NMR metabolite fingerprinting.

PubMed

Petrakis, Eleftherios A; Cagliani, Laura R; Polissiou, Moschos G; Consonni, Roberto

2015-04-15

In the present work, a preliminary study for the detection of adulterated saffron and the identification of the adulterant used by means of (1)H NMR and chemometrics is reported. Authentic Greek saffron and four typical plant-derived materials utilised as bulking agents in saffron, i.e., Crocus sativus stamens, safflower, turmeric, and gardenia were investigated. A two-step approach, relied on the application of both OPLS-DA and O2PLS-DA models to the (1)H NMR data, was adopted to perform authentication and prediction of authentic and adulterated saffron. Taking into account the deficiency of established methodologies to detect saffron adulteration with plant adulterants, the method developed resulted reliable in assessing the type of adulteration and could be viable for dealing with extensive saffron frauds at a minimum level of 20% (w/w). Copyright © 2014 Elsevier Ltd. All rights reserved.

Interactive effects of saffron with garlic and curcumin against cyclophosphamide induced genotoxicity in mice.

PubMed

Premkumar, Kumpati; Kavitha, Sundramoorthy; Santhiya, Sathiyavedu T; Ramesh, A-Rabandi; Suwanteerangkul, Jiraporn

2004-01-01

Saffron is a well-known spice and food colorant commonly consumed in different parts of the world. Recently, much attention has been focused on the biological and medicinal properties of saffron. In the present study the interactive effects of saffron with two commonly consumed dietary agents, garlic and curcumin was evaluated for anti-genotoxic effects against cyclophosphamide (CPH) in the mouse bone marrow micronucleus test. Experimental animals were orally pretreated with saffron (100 mg/kg body weight), garlic (250 mg/kg body weight) and curcumin (10 mg/kg body weight), either alone or in combination for five consecutive days, 2h prior to the administration of CPH. Maximum reduction in the frequencies of micronucleated polychromatic erythrocytes (Mn PCEs) induced by CPH was observed when all the three test compounds were administered together. Furthermore, the protective effects were more pronounced in the garlic-administered groups compared to curcumin and/or saffron administered groups.

Identification of genes specifically or preferentially expressed in maize silk reveals similarity and diversity in transcript abundance of different dry stigmas.

PubMed

Xu, Xiao Hui; Chen, Hao; Sang, Ya Lin; Wang, Fang; Ma, Jun Ping; Gao, Xin-Qi; Zhang, Xian Sheng

2012-07-02

In plants, pollination is a critical step in reproduction. During pollination, constant communication between male pollen and the female stigma is required for pollen adhesion, germination, and tube growth. The detailed mechanisms of stigma-mediated reproductive processes, however, remain largely unknown. Maize (Zea mays L.), one of the world's most important crops, has been extensively used as a model species to study molecular mechanisms of pollen and stigma interaction. A comprehensive analysis of maize silk transcriptome may provide valuable information for investigating stigma functionality. A comparative analysis of expression profiles between maize silk and dry stigmas of other species might reveal conserved and diverse mechanisms that underlie stigma-mediated reproductive processes in various plant species. Transcript abundance profiles of mature silk, mature pollen, mature ovary, and seedling were investigated using RNA-seq. By comparing the transcriptomes of these tissues, we identified 1,427 genes specifically or preferentially expressed in maize silk. Bioinformatic analyses of these genes revealed many genes with known functions in plant reproduction as well as novel candidate genes that encode amino acid transporters, peptide and oligopeptide transporters, and cysteine-rich receptor-like kinases. In addition, comparison of gene sets specifically or preferentially expressed in stigmas of maize, rice (Oryza sativa L.), and Arabidopsis (Arabidopsis thaliana [L.] Heynh.) identified a number of homologous genes involved either in pollen adhesion, hydration, and germination or in initial growth and penetration of pollen tubes into the stigma surface. The comparison also indicated that maize shares a more similar profile and larger number of conserved genes with rice than with Arabidopsis, and that amino acid and lipid transport-related genes are distinctively overrepresented in maize. Many of the novel genes uncovered in this study are potentially involved

Identification of genes specifically or preferentially expressed in maize silk reveals similarity and diversity in transcript abundance of different dry stigmas

PubMed Central

2012-01-01

Background In plants, pollination is a critical step in reproduction. During pollination, constant communication between male pollen and the female stigma is required for pollen adhesion, germination, and tube growth. The detailed mechanisms of stigma-mediated reproductive processes, however, remain largely unknown. Maize (Zea mays L.), one of the world’s most important crops, has been extensively used as a model species to study molecular mechanisms of pollen and stigma interaction. A comprehensive analysis of maize silk transcriptome may provide valuable information for investigating stigma functionality. A comparative analysis of expression profiles between maize silk and dry stigmas of other species might reveal conserved and diverse mechanisms that underlie stigma-mediated reproductive processes in various plant species. Results Transcript abundance profiles of mature silk, mature pollen, mature ovary, and seedling were investigated using RNA-seq. By comparing the transcriptomes of these tissues, we identified 1,427 genes specifically or preferentially expressed in maize silk. Bioinformatic analyses of these genes revealed many genes with known functions in plant reproduction as well as novel candidate genes that encode amino acid transporters, peptide and oligopeptide transporters, and cysteine-rich receptor-like kinases. In addition, comparison of gene sets specifically or preferentially expressed in stigmas of maize, rice (Oryza sativa L.), and Arabidopsis (Arabidopsis thaliana [L.] Heynh.) identified a number of homologous genes involved either in pollen adhesion, hydration, and germination or in initial growth and penetration of pollen tubes into the stigma surface. The comparison also indicated that maize shares a more similar profile and larger number of conserved genes with rice than with Arabidopsis, and that amino acid and lipid transport-related genes are distinctively overrepresented in maize. Conclusions Many of the novel genes uncovered in this

Cold low pressure O2 plasma treatment of Crocus sativus: An efficient way to eliminate toxicogenic fungi with minor effect on molecular and cellular properties of saffron.

PubMed

Hosseini, Seyed Iman; Farrokhi, Naser; Shokri, Khadijeh; Khani, Mohammad Reza; Shokri, Babak

2018-08-15

In this study cold low pressure radiofrequency oxygen plasma was used for the first time to inactivate toxicogenic fungi proliferation on saffron. Varieties of plasma produced reactive oxygen species which were investigated by optical emission spectroscopy. The data were indicative of the absence of UV radiation. Effects of plasma treatment on antioxidant activity, metabolic content, colour, odour and flavour parameters and physical impact on saffron were investigated. A range of plasma powers and exposure times were assayed in suppression of fungal growth. Amongst which power of 60 W for 15 min was used to eradicate Aspergillus and other microorganisms. The ferric reducing antioxidant power was changed from 1778.21 to 1674.25 mM/g dry weight following plasma treatment. Moreover, crocin ester, picrocrocin and safranal metabolites reduced insignificantly. Additionally, plasma had no significant impact on colour, odour and flavour of saffron. Copyright © 2018 Elsevier Ltd. All rights reserved.

On the Traceability of Commercial Saffron Samples Using ¹H-NMR and FT-IR Metabolomics.

PubMed

Consonni, Roberto; Ordoudi, Stella A; Cagliani, Laura R; Tsiangali, Maria; Tsimidou, Maria Z

2016-02-29

In previous works on authentic samples of saffron of known history (harvest and processing year, storage conditions, and length of time) some biomarkers were proposed using both FT-IR and NMR metabolomics regarding the shelf life of the product. This work addresses the difficulties to trace back the "age" of commercial saffron samples of unknown history, sets a limit value above which these products can be considered substandard, and offers a useful tool to combat saffron mislabeling and fraud with low-quality saffron material. Investigations of authentic and commercial saffron samples of different origin and harvest year, which had been stored under controlled conditions for different lengths of time, allowed a clear-cut clustering of samples in two groups according to the storage period irrespectively of the provenience. In this respect, the four-year cut off point proposed in our previous work assisted to trace back the "age" of unknown samples and to check for possible mislabeling practices.

Saffron: a promising natural medicine in the treatment of metabolic syndrome.

PubMed

Razavi, Bibi Marjan; Hosseinzadeh, Hossein

2017-04-01

Metabolic syndrome is a disorder which encompasses obesity, high blood glucose, high cholesterol levels and high blood pressure. Moreover, metabolic syndrome is considered as the most important risk factor for cardiovascular disease (CVD). CVD is the leading cause of mortality in the world for both men and women. Several chemical drugs are available to treat metabolic risk factors, but because of the safety, efficacy, cultural acceptability and lesser side effects, nowadays herbal therapy has a critical role in the treatment of these CVD risk factors. Crocus sativus L. (saffron) is a perennial herb that belongs to the Iridaceae family. Saffron is an extensively used food additive for its colour and taste and has been widely used in traditional as well as modern medicine to treat several illnesses including cardiovascular diseases. Most of the unique properties of this plant are attributed to the presence of three major components, including crocin, safranal and crocetin. It has been proved that saffron has an important role in the management of metabolic syndrome because of its marvelous activities including anti-diabetic, anti-obesity, hypotensive and hypolipidaemic properties. In this review article, we discuss the beneficial properties of saffron and its active components to treat different components of metabolic syndrome and most relevant animal and human studies regarding the use of this plant in cardiovascular disease, with focus on the metabolic risk factors. This review also suggests that after randomised clinical trials, saffron may be implicated as a preventive or therapeutic agent against metabolic syndrome. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Quality assessment of the saffron samples using second-order spectrophotometric data assisted by three-way chemometric methods via quantitative analysis of synthetic colorants in adulterated saffron

NASA Astrophysics Data System (ADS)

Masoum, Saeed; Gholami, Ali; Hemmesi, Marjan; Abbasi, Saleheh

2015-09-01

Saffron is a valuable culinary spice that can be used not only for dyes and cooking, but also for many medical purposes. Due to its high price and restriction of its production, various fraud manners in its production have been growing. Addition of synthetic colorants to saffron is the most common way for adulteration. In this work, chemometric methods are proposed to resolve the three-dimensional absorbance spectra-pH data for simultaneous determination of the two colorants Tartrazin and Sunset yellow, in adulterated saffron. The rank deficiency in the concentration mode impaired the system. Therefore, to extirpate the ambiguity, which results from rank deficiency, three-way variation array V was generated by subtracting the first pH spectrum from each spectrum at each pH. This allows the extraction of extent reaction profile and mixture reaction spectral profiles, as well as the relative concentrations of the analytes.

Saffron with resistance exercise improves diabetic parameters through the GLUT4/AMPK pathway in-vitro and in-vivo

PubMed Central

Dehghan, Firouzeh; Hajiaghaalipour, Fatemeh; Yusof, Ashril; Muniandy, Sekaran; Hosseini, Seyed Ali; Heydari, Sedigheh; Salim, Landa Zeenelabdin Ali; Azarbayjani, Mohammad Ali

2016-01-01

Saffron is consumed as food and medicine to treat several illnesses. This study elucidates the saffron effectiveness on diabetic parameters in-vitro and combined with resistance exercise in-vivo. The antioxidant properties of saffron was examined. Insulin secretion and glucose uptake were examined by cultured RIN-5F and L6 myotubes cells. The expressions of GLUT2, GLUT4, and AMPKα were determined by Western blot. Diabetic and non-diabetic male rats were divided into: control, training, extract treatment, training + extract treatment and metformin. The exercise and 40 mg/kg/day saffron treatments were carried out for six weeks. The antioxidant capacity of saffron was higher compare to positive control (P < 0.01). High dose of saffron stimulated insulin release in RIN-5F cells and improved glucose uptake in L6 myotubes. GLUT4 and AMPKα expressions increased in both doses of saffron (P < 0.01), whereas GLUT2 not changed (p > 0.05). Serum glucose, cholesterol, triglyceride, low-density lipoprotein, very low-density lipoprotein, insulin resistance, and glycated hemoglobin levels decreased in treated rats compared to untreated (p < 0.01). However, no significant differences were observed in the high-density lipoprotein, insulin, adiponectin, and leptin concentration levels in all groups (p > 0.05). The findings suggest that saffron consuming alongside exercise could improve diabetic parameters through redox-mediated mechanisms and GLUT4/AMPK pathway to entrap glucose uptake. PMID:27122001

Molecular cloning and expression of Cro s 1: an occupational allergen from saffron pollen (Crocus sativus)

PubMed Central

Varasteh, Abdol-Reza; Sankian, Mojtaba; Midoro-Horiuti, Terumi; Moghadam, Malihe; Shakeri, Mohamad Taghi; Brooks, Edward G.; Goldblum, Randall M.; Chapman, Martin D.; Pomés, Anna

2012-01-01

Background: The cultivation of saffron is expanding through the southeast of Iran, and allergy to saffron pollen occurs in workers involved in processing this plant. We aimed to clone, sequence and express a major allergen involved in saffron pollen allergy, and to compare the recombinant with the natural allergen. Methods: The N-terminal amino acid sequence of Cro s 1, an allergen from saffron pollen, was determined after immunoblotting. The cDNA encoding for this allergen was cloned by PCR utilizing a primer based on the N-terminal amino acid sequence. Recombinant Cro s 1 (rCro s 1) was expressed as a soluble protein in Pichia pastoris and purified to homogeneity by gel filtration. Inhibition of IgE binding to rCro s 1 by pollen extract was analyzed by ELISA. Section Title The allergen Cro s 1 was identified from saffron pollen extracts and cloned by PCR. Cro s 1 cDNA defined an acidic polypeptide with homology to pollen proteins from Chenopodium album and Ligastrum vulgaris. The rCro s 1 was expressed in P. pastoris at 28 mg/l. Saffron pollen extract inhibited the binding of patient serum IgE to rCro s 1. Conclusion: We identified and cloned the first Crocus sativus pollen allergen. rCro s 1 cDNA shows a very high homology with Che a 1, the major allergen of lamb's-quarter, Chenopodium album, Caryophyllales, pollen (97%). Cro s 1 is a useful tool for specific diagnosis and structural studies of occupational allergy to saffron. PMID:26989701

Molecular cloning and expression of Cro s 1: an occupational allergen from saffron pollen (Crocus sativus).

PubMed

Varasteh, Abdol-Reza; Sankian, Mojtaba; Midoro-Horiuti, Terumi; Moghadam, Malihe; Shakeri, Mohamad Taghi; Brooks, Edward G; Goldblum, Randall M; Chapman, Martin D; Pomés, Anna

2012-10-01

The cultivation of saffron is expanding through the southeast of Iran, and allergy to saffron pollen occurs in workers involved in processing this plant. We aimed to clone, sequence and express a major allergen involved in saffron pollen allergy, and to compare the recombinant with the natural allergen. The N-terminal amino acid sequence of Cro s 1, an allergen from saffron pollen, was determined after immunoblotting. The cDNA encoding for this allergen was cloned by PCR utilizing a primer based on the N-terminal amino acid sequence. Recombinant Cro s 1 (rCro s 1) was expressed as a soluble protein in Pichia pastoris and purified to homogeneity by gel filtration. Inhibition of IgE binding to rCro s 1 by pollen extract was analyzed by ELISA. The allergen Cro s 1 was identified from saffron pollen extracts and cloned by PCR. Cro s 1 cDNA defined an acidic polypeptide with homology to pollen proteins from Chenopodium album and Ligastrum vulgaris. The rCro s 1 was expressed in P. pastoris at 28 mg/l. Saffron pollen extract inhibited the binding of patient serum IgE to rCro s 1. We identified and cloned the first Crocus sativus pollen allergen. rCro s 1 cDNA shows a very high homology with Che a 1, the major allergen of lamb's-quarter, Chenopodium album, Caryophyllales, pollen (97%). Cro s 1 is a useful tool for specific diagnosis and structural studies of occupational allergy to saffron.

Saffron: A Natural Potent Antioxidant as a Promising Anti-Obesity Drug

PubMed Central

Mashmoul, Maryam; Azlan, Azrina; Khaza’ai, Huzwah; Mohd Yusof, Barakatun Nisak; Mohd Noor, Sabariah

2013-01-01

Obesity is associated with various diseases, particularly diabetes, hypertension, osteoarthritis and heart disease. Research on possibilities of herbal extracts and isolated compounds from natural products for treating obesity has an upward trend. Saffron (Crocus Sativus L. Iridaceae) is a source of plant polyphenols/carotenoids, used as important spice and food colorant in different parts of the world. It has also been used in traditional medicine for treatment of different types of illnesses since ancient times. Many of these medicinal properties of saffron can be attributed to a number of its compounds such as crocetin, crocins and other substances having strong antioxidant and radical scavenger properties against a variety of radical oxygen species and pro-inflammatory cytokines. The aim of this article is to assess the potential role of saffron and its constituents in the regulation of metabolic functions, which can beneficially alter obesity pathophysiology. PMID:26784466

Saffron Samples of Different Origin: An NMR Study of Microwave-Assisted Extracts

PubMed Central

Sobolev, Anatoly P.; Carradori, Simone; Capitani, Donatella; Vista, Silvia; Trella, Agata; Marini, Federico; Mannina, Luisa

2014-01-01

An NMR analytical protocol is proposed to characterize saffron samples of different geographical origin (Greece, Spain, Hungary, Turkey and Italy). A microwave-assisted extraction procedure was developed to obtain a comparable recovery of metabolites with respect to the ISO specifications, reducing the solvent volume and the extraction time needed. Metabolite profiles of geographically different saffron extracts were compared showing significant differences in the content of some metabolites. PMID:28234327

A comprehensive review of the pharmacological potential of Crocus sativus and its bioactive apocarotenoids.

PubMed

Bukhari, Syed Imran; Manzoor, Mahreen; Dhar, M K

2018-02-01

Crocus sativus is an herbaceous plant that belongs to family Iridaceae. It is commonly known as saffron and has been used for medicinal purposes since many centuries in India and other parts of the world. Saffron of commercial importance comprises of dried stigmas of the plant and is rich in flavonoids, vitamins, and carotenoids. Carotenoids represent the main components of saffron and their cleavage results in the formation of apocarotenoids such as crocin, picrocrocin, and safranal. Studies conducted during the past two decades have revealed the immense therapeutic potential of saffron. Most of the therapeutic properties are due to the presence of unique apocarotenoids having strong free radical scavenging activity. The mode of action of these apocarotenoids could be: modulatory effects on detoxifying enzymes involved in combating oxidative stress, decreasing telomerase activity, increased the proapoptotic effect, inhibition of DNA, RNA and protein synthesis, and by a strong binding capacity of crocetin with tRNA. The present review focuses on the therapeutic role of saffron and its bio oxidative cleavage products and also highlights the possible molecular mechanism of action. The findings reported in this review describes the wide range of applications of saffron and attributes its free radical scavenging nature the main property which makes this spice a potent chemotherapeutic agent for the treatment of various diseases. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Using ß-cyclodextrin and Arabic Gum as Wall Materials for Encapsulation of Saffron Essential Oil

PubMed Central

Atefi, Mohsen; Nayebzadeh, Kooshan; Mohammadi, Abdorreza; Mortazavian, Amir Mohammad

2017-01-01

Saffron essential oil has a pleasant aroma and medicinal activities. However, it is sensible into the environmental condition. Therefore, it should be protected against unwanted changes during storage or processing. Encapsulation is introduced as a process by which liable materials are protected from unwanted changes. In the present study, different ratios (0:100, 25:75, 50:50, 75:25, and 100:0) of ß-cyclodextrin (ß-CD) and arabic gum (GA) were used as wall martial for encapsulation saffron essential oil. In order to calculate of loading capacity (LC) and encapsulation efficiency (EE), and release (RE), safranal was determined as indicator of saffron essential oil using GC. According to the results, the highest LC and EE were related to the mixture of ß-CD/GA at a 75:25 ratio. In contrast, the lowest encapsulate hygroscopicity (EH) and RE were observed when only ß-CD was applied as wall material (P≤0.05). Comparing the differential scanning calorimetry (DSC) thermograms of the control and encapsulate of ß-CD/GA (75:25) confirmed encapsulation of saffron essential oil. Scanning electron microscopy (SEM) images with high magnifications showed the rhombic structure that partially coated by GA. The mixture of ß-CD/GA at a 75:25 ratio can be recommended for saffron essential oil encapsulation. PMID:28496464

Using ß-cyclodextrin and Arabic Gum as Wall Materials for Encapsulation of Saffron Essential Oil.

PubMed

Atefi, Mohsen; Nayebzadeh, Kooshan; Mohammadi, Abdorreza; Mortazavian, Amir Mohammad

2017-01-01

Saffron essential oil has a pleasant aroma and medicinal activities. However, it is sensible into the environmental condition. Therefore, it should be protected against unwanted changes during storage or processing. Encapsulation is introduced as a process by which liable materials are protected from unwanted changes. In the present study, different ratios (0:100, 25:75, 50:50, 75:25, and 100:0) of ß-cyclodextrin (ß-CD) and arabic gum (GA) were used as wall martial for encapsulation saffron essential oil. In order to calculate of loading capacity (LC) and encapsulation efficiency (EE), and release (RE), safranal was determined as indicator of saffron essential oil using GC. According to the results, the highest LC and EE were related to the mixture of ß-CD/GA at a 75:25 ratio. In contrast, the lowest encapsulate hygroscopicity (EH) and RE were observed when only ß-CD was applied as wall material (P≤0.05). Comparing the differential scanning calorimetry (DSC) thermograms of the control and encapsulate of ß-CD/GA (75:25) confirmed encapsulation of saffron essential oil. Scanning electron microscopy (SEM) images with high magnifications showed the rhombic structure that partially coated by GA. The mixture of ß-CD/GA at a 75:25 ratio can be recommended for saffron essential oil encapsulation.

Rapid determination of crocins in saffron by near-infrared spectroscopy combined with chemometric techniques

NASA Astrophysics Data System (ADS)

Li, Shuailing; Shao, Qingsong; Lu, Zhonghua; Duan, Chengli; Yi, Haojun; Su, Liyang

2018-02-01

Saffron is an expensive spice. Its primary effective constituents are crocin I and II, and the contents of these compounds directly affect the quality and commercial value of saffron. In this study, near-infrared spectroscopy was combined with chemometric techniques for the determination of crocin I and II in saffron. Partial least squares regression models were built for the quantification of crocin I and II. By comparing different spectral ranges and spectral pretreatment methods (no pretreatment, vector normalization, subtract a straight line, multiplicative scatter correction, minimum-maximum normalization, eliminate the constant offset, first derivative, and second derivative), optimum models were developed. The root mean square error of cross-validation values of the best partial least squares models for crocin I and II were 1.40 and 0.30, respectively. The coefficients of determination for crocin I and II were 93.40 and 96.30, respectively. These results show that near-infrared spectroscopy can be combined with chemometric techniques to determine the contents of crocin I and II in saffron quickly and efficiently.

Cardioprotective effect of saffron extract and safranal in isoproterenol-induced myocardial infarction in wistar rats.

PubMed

Mehdizadeh, Roya; Parizadeh, Mohammad-Reza; Khooei, Ali-Reza; Mehri, Soghra; Hosseinzadeh, Hossein

2013-01-01

This study was designed to evaluate the cardioprotective effect of Crocus sativus L. (saffron) aqueous extract and safranal, the major constituent of the essential oil of saffron, on lipid peroxidation, biochemical parameters and histopathological findings in isoproterenol (ISO)-induced myocardial infarction in Wistar rats. The saffron extract (20, 40, 80 and 160 mg/kg/day IP) or control were administered for 9 days along with ISO (85 mg/kg, SC, at 24 hr interval) on 8th and 9th day in rats. Activities of creatine kinase-muscle, brain (CK-MB) and lactate dehydrogenase (LDH) were measured using standard commercial kits. The level of malondialdehyde in heart tissue was estimated with thiobarbituric acid reactive species test. For histopathological examination, hematoxylin and eosin (H&E) staining was used. ISO administration induced a statistically significant increase (P< 0.001) in serum LDH and CK-MB and a significant increase (P< 0.001) in the levels of thiobarbituric acid reactive substances (TBARs) in the heart as compared to vehicle control rats. Saffron pretreatment (20, 40, 80 and 160 mg/kg IP) or safranal pretreatment (0.025, 0.050, 0.075 ml/kg IP) for 8 days, significantly decreased (P< 0.001) the serum LDH and CK-MB and myocardial lipid peroxidation as compared to ISO- induced rats. Histological findings of the heart sections confirmed myocardial injury with ISO administration and preserved nearly normal tissue architecture with saffron or safranal pretreatment. Saffron and safranal may have cardioprotective effect in ISO-induced myocardial infarction through modulation of oxidative stress in such a way that they maintain the redox status of the cell.

The Effect of Saffron on Depression among Recovered Consumers of Methamphetamine Living with HIV/AIDS.

PubMed

Jalali, Farzad; Hashemi, Seyedeh Fatemeh

2018-03-15

From one hand, depression is one of the symptoms that occur after abstinence from methamphetamine. On the other people living with HIV/AIDS are in isolation due to the nature of their illness and depression is one of the most common mental health problems they experience. This study was aimed at determining the effectiveness of saffron on reducing depression among recovered consumers of methamphetamine living with HIV/AIDS. The design of this study was semi-experimental with pre-test, post-test and control (placebo) groups. The statistical population consisted of all recovered consumers of methamphetamine living with HIV/AIDS who were referred to the Positive Club. Fifty-seven (57) recovered consumers of methamphetamine, living with HIV/AIDS, were selected by convenience sampling method. They were randomly assigned to an experimental (saffron) group and a control (placebo) group. The experimental group received 30 ml of saffron per day for 8 weeks, whereas the control (placebo) group received placebo the same way. BDI-II was used in this study as a measurement instrument. ANCOVA models were used for statistical inference. The findings showed that saffron and its ingredients had been effective in reducing depression among this group (P < 0.05). In fact, saffron with its active ingredients (Crusin and Saffranal) by serotonin and dopamine secretion in the brain, help in reducing depression among recovered consumers of methamphetamine living with HIV/AIDS.

The anticancer effect of saffron in two p53 isogenic colorectal cancer cell lines

PubMed Central

2012-01-01

Background Saffron extract, a natural product, has been shown to induce apoptosis in several tumor cell lines. Nevertheless, the p53-dependency of saffron’s mechanism of action in colon cancer remains unexplored. Material and methods In order to examine saffron’s anti-proliferative and pro-apoptotic effects in colorectal cancer cells, we treated two p53 isogenic HCT116 cell lines (HCT wildtype and HCT p53−/−) with different doses of the drug and analyzed cell proliferation and apoptosis in a time-dependent manner. MTT viability and crystal violet assays were performed in order to determine the effective dose of saffron on both cell lines. The cell cycle progress was examined by Flow cytometric analysis. Apoptosis was assessed using Annexin-PI-staining and Western Blotting for caspase 3 and PARP cleavage. Autophagy was determined by Western Blotting of the light chain 3 (LC3)-II and Beclin 1 proteins. The protein content of phospho-H2AX (γH2AX), a sensor of DNA double strand breaks, was also analyzed by Western Blotting. Results Saffron extract induced a p53-dependent pattern of cell cycle distribution with a full G2/M stop in HCT116 p53 wildtype cells. However, it induced a remarkable delay in S/G2 phase transit with entry into mitosis in HCT116 p53 −/− cells. The apoptotic Pre-G1 cell fraction as well as Annexin V staining and caspase 3 cleavage showed a more pronounced apoptosis induction in HCT116 p53 wildtype cells. Obviously, the significantly higher DNA-damage, reflected by ɣH2AX protein levels in cells lacking p53, was coped by up-regulation of autophagy. The saffron-induced LC3-II protein level was a remarkable indication of the accumulation of autophagosomes, a response to the cellular stress condition of drug treatment. Conclusions This is the first study showing the effect of saffron in HCT116 colorectal cancer cells with different p53 status. Saffron induced DNA-damage and apoptosis in both cell lines. However, autophagy has delayed the

A systematic review of randomized controlled trials examining the effectiveness of saffron (Crocus sativus L.) on psychological and behavioral outcomes.

PubMed

Hausenblas, Heather Ann; Heekin, Kacey; Mutchie, Heather Lee; Anton, Stephen

2015-07-01

Throughout the past three decades, increased scientific attention has been given to examining saffron's (Crocus sativus L.) use as a potential therapeutic or preventive agent for a number of health conditions, including cancer, cardiovascular disease, and depression. The purpose of this systematic review is to examine and categorize the current state of scientific evidence from randomized controlled trials (RCTs) regarding the efficacy of saffron on psychological/behavioral outcomes. Electronic and non-electronic systematic searches were conducted to identify all relevant human clinical research on saffron. The search strategy was extensive and was designed according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)." Reference lists of articles that met the inclusion criteria were searched. Only English language studies were reviewed. Saffron trials in combination with other substances and saffron safety studies were considered, in accordance with the PRISMA statement. Included studies must have a control group. Included studies must measure a physiological and/or a behavioral outcome. The methodological quality of all included studies was independently evaluated by two reviewers using the Jadad score. Mean scores and P-values of measures were compared both inter- and intra-study for each parameter (i.e., depression). Twelve studies met our inclusion criteria. These studies examined the effects of saffron on psychological/behavioral outcomes of: major depressive disorder (n=6), premenstrual syndrome (n = 1), sexual dysfunction and infertility (n=4), and weight loss/snacking behaviors (n=1). The data from these studies support the efficacy of saffron as compared to placebo in improving the following conditions: depressive symptoms (compared to anti-depressants and placebo), premenstrual symptoms, and sexual dysfunction. In addition, saffron use was also effective in reducing excessive snacking behavior. Findings from initial

Nephrotoxicity and hepatotoxicity evaluation of Crocus sativus stigmas in neonates of nursing mice

PubMed Central

Bahmani, Mahmoud; Rafieian, Mortaza; Baradaran, Azar; Rafieian, Samira; Rafieian-kopaei, Mahmoud

2014-01-01

Background: Crocus sativus, known as saffron crocus, is best known for the spice saffron. Saffron use spans more than 3500 years, however, its toxicity on neonates during lactation has not yet evaluated. Objectives: This study was aimed to examine the acute toxicity of saffron on adult mice and its nephrotoxicity and hepatotoxicity on neonates of lactating mothers that used saffron during lactation. Materials and Methods: In this experimental study, following acute toxicity evaluation, 32 pregnant mice were randomly designated into four equal groups. Following delivery, the mothers of groups 1 to 4 were administered orally (by gavage) normal saline (control group), 500, 1000 or 2000 mg/kg/day of saffron for three weeks, respectively. The newborn’s kidney and liver parameters were assessed at the end of the study for possible nephrotoxicity and hepatotoxicity evaluation. The kidney and liver tissue samples of newborns were histopathologically studied after staining with Hematoxylin & Eosin. Data were analyzed using ANOVA and Scheffe’s tests Results: The LD50 value of saffron was calculated to be 4120±556 mg/kg in mice. To evaluate lactating toxicity, saffron was administered orally to the mothers once daily for 21 days, after delivery, during lactating period. Saffron increased serum urea nitrogen (p< 0.05). Histological studies indicated that saffron did not have any toxic effect on liver, however, histopathology changes were seen in the kidney of neonates. Conclusions: From the results of present study, it might be concluded that saffron is a nearly safe spice, however, nursing mothers should avoid high doses of this spice. PMID:24772401

Gene and noncoding RNA regulation underlying photoreceptor protection: microarray study of dietary antioxidant saffron and photobiomodulation in rat retina

PubMed Central

Zhu, Yuan; Valter, Krisztina; Bisti, Silvia; Eells, Janis; Stone, Jonathan

2010-01-01

Purpose To identify the genes and noncoding RNAs (ncRNAs) involved in the neuroprotective actions of a dietary antioxidant (saffron) and of photobiomodulation (PBM). Methods We used a previously published assay of photoreceptor damage, in which albino Sprague Dawley rats raised in dim cyclic illumination (12 h 5 lux, 12 h darkness) were challenged by 24 h exposure to bright (1,000 lux) light. Experimental groups were protected against light damage by pretreatment with dietary saffron (1 mg/kg/day for 21 days) or PBM (9 J/cm2 at the eye, daily for 5 days). RNA from one eye of four animals in each of the six experimental groups (control, light damage [LD], saffron, PBM, saffronLD, and PBMLD) was hybridized to Affymetrix rat genome ST arrays. Quantitative real-time PCR analysis of 14 selected genes was used to validate the microarray results. Results LD caused the regulation of 175 entities (genes and ncRNAs) beyond criterion levels (p<0.05 in comparison with controls, fold-change >2). PBM pretreatment reduced the expression of 126 of these 175 LD-regulated entities below criterion; saffron pretreatment reduced the expression of 53 entities (50 in common with PBM). In addition, PBM pretreatment regulated the expression of 67 entities not regulated by LD, while saffron pretreatment regulated 122 entities not regulated by LD (48 in common with PBM). PBM and saffron, given without LD, regulated genes and ncRNAs beyond criterion levels, but in lesser numbers than during their protective action. A high proportion of the entities regulated by LD (>90%) were known genes. By contrast, ncRNAs were prominent among the entities regulated by PBM and saffron in their neuroprotective roles (73% and 62%, respectively). Conclusions Given alone, saffron and (more prominently) PBM both regulated significant numbers of genes and ncRNAs. Given before retinal exposure to damaging light, thus while exerting their neuroprotective action, they regulated much larger numbers of entities

Effect of Saffron on Metabolic Profile and Retina in Apolipoprotein E-Knockout Mice Fed a High-Fat Diet.

PubMed

Doumouchtsis, Evangelos K; Tzani, Aspasia; Doulamis, Ilias P; Konstantopoulos, Panagiotis; Laskarina-Maria, Korou; Agrogiannis, Georgios; Agapitos, Emmanouil; Moschos, Marilita M; Kostakis, Alkiviadis; Perrea, Despina N

2017-09-22

Saffron is a spice that has been traditionally used as a regimen for a variety of diseases due to its potent antioxidant attributes. It is well documented that impaired systemic oxidative status is firmly associated with diverse adverse effects including retinal damage. The aim of this study was to investigate the role of saffron administration against the retinal damage in apoE -/- mice fed a high-fat diet, since they constitute a designated experimental model susceptible to oxidative stress. Twenty-one mice were allocated into three groups: Group A (control, n = 7 c57bl/6 mice) received standard chow diet; Group B (high-fat, n = 7 apoE -/- mice) received a high-fat diet; and Group C (high-fat and saffron, n = 7 apoE -/- mice) received a high-fat diet and saffron (25 mg/kg/d) through their drinking water. The duration of the study was 20 weeks. Lipidemic profile, glucose, C-reactive protein (CRP), and total oxidative capacity (PerOX) were measured in blood serum. Histological analysis of retina was also conducted. Administration of saffron resulted in enhanced glycemic control and preservation of retinal thickness when compared with apoE -/- mice fed a high-fat diet. The outcomes of the study suggest the potential protective role of saffron against retinal damage induced by oxidative stress. Nevertheless, verification of these results in humans is required before any definite conclusions can be drawn.

Ameliorative Effect of Saffron Aqueous Extract on Hyperglycemia, Hyperlipidemia, and Oxidative Stress on Diabetic Encephalopathy in Streptozotocin Induced Experimental Diabetes Mellitus

PubMed Central

Samarghandian, Saeed; Azimi-Nezhad, Mohsen; Samini, Fariborz

2014-01-01

Diabetic encephalopathy is one of the severe complications in patients with diabetes mellitus. Findings indicate that saffron extract has antioxidant properties but its underlying beneficial effects on diabetic encephalopathy were unclear. In the present study, the protective activities of saffron were evaluated in diabetic encephalopathy. Saffron at 40 and 80 mg/kg significantly increased body weight and serum TNF-α and decreased blood glucose levels, glycosylated serum proteins, and serum advanced glycation endproducts (AGEs) levels. Furthermore, significant increase in HDL and decrease (P < 0.05) in cholesterol, triglyceride, and LDL were observed after 28 days of treatment. At the end of experiments, the hippocampus tissue was used for determination of glutathione content (GSH), superoxide dismutase (SOD), and catalase (CAT) activities. Furthermore, saffron significantly increased GSH, SOD, and CAT but remarkably decreased cognitive deficit, serum TNF-α, and induced nitric oxide synthase (iNOS) activity in hippocampus tissue. Our findings indicated that saffron extract may reduce hyperglycemia and hyperlipidemia risk and also reduce the oxidative stress in diabetic encephalopathy rats. This study suggested that saffron extract might be a promising candidate for the improvement of chemically induced diabetes and its complications. PMID:25114929

Saffron, passionflower, valerian and sage for mental health.

PubMed

Modabbernia, Amirhossein; Akhondzadeh, Shahin

2013-03-01

Many cultures have developed folk herbal remedies to treat symptoms of mental illness. An evidence-based view is now being developed for some of these so-called alternative herbal treatments. This article discusses clinically relevant scientific information on medicinal extracts of 4 herbs: saffron, passionflower, valerian, and sage. Copyright © 2013 Elsevier Inc. All rights reserved.

An image analysis of TLC patterns for quality control of saffron based on soil salinity effect: A strategy for data (pre)-processing.

PubMed

Sereshti, Hassan; Poursorkh, Zahra; Aliakbarzadeh, Ghazaleh; Zarre, Shahin; Ataolahi, Sahar

2018-01-15

Quality of saffron, a valuable food additive, could considerably affect the consumers' health. In this work, a novel preprocessing strategy for image analysis of saffron thin layer chromatographic (TLC) patterns was introduced. This includes performing a series of image pre-processing techniques on TLC images such as compression, inversion, elimination of general baseline (using asymmetric least squares (AsLS)), removing spots shift and concavity (by correlation optimization warping (COW)), and finally conversion to RGB chromatograms. Subsequently, an unsupervised multivariate data analysis including principal component analysis (PCA) and k-means clustering was utilized to investigate the soil salinity effect, as a cultivation parameter, on saffron TLC patterns. This method was used as a rapid and simple technique to obtain the chemical fingerprints of saffron TLC images. Finally, the separated TLC spots were chemically identified using high-performance liquid chromatography-diode array detection (HPLC-DAD). Accordingly, the saffron quality from different areas of Iran was evaluated and classified. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Survey on Saffron in Major Islamic Traditional Medicine Books

PubMed Central

Javadi, Behjat; Sahebkar, Amirhossein; Emami, Seyed Ahmad

2013-01-01

Islamic Traditional Medicine (ITM) is a holistic system of medicine. Saffron (Crocus sativus) is one of the most famous plants cultivated in Iran and has a wide range of activities such as oxytocic, anti-carcinogenic, exhilarant, anti-depressant, and anti-asthma effects. In addition, saffron can increase the bioavailability and enhance absorption of other drugs. This study comprises a bibliographical survey of 13 major ITM books regarding different medical aspects of this species. Ferdows al-Hekmah fi’l-Tibb (The Paradise of Wisdom in Medicine), Al-Hawi fi’l-Tibb (Comprehensive Book of Medicine), Kamel al-Sanaat al-Tibbyyah (Complete Book of the Medical Art), Al-Qanun fi’l-Tibb (Canon of Medicine), Zakhireh Kharazmshahi (Treasure of Kharazmshahi), and Makhzan al-Adwiah (Drug Treasure) are some of the most important ITM books used in this survey. PMID:23638288

Geographical identification of saffron (Crocus sativus L.) by linear discriminant analysis applied to the UV-visible spectra of aqueous extracts.

PubMed

D'Archivio, Angelo Antonio; Maggi, Maria Anna

2017-03-15

We attempted geographical classification of saffron using UV-visible spectroscopy, conventionally adopted for quality grading according to the ISO Normative 3632. We investigated 81 saffron samples produced in L'Aquila, Città della Pieve, Cascia, and Sardinia (Italy) and commercial products purchased in various supermarkets. Exploratory principal component analysis applied to the UV-vis spectra of saffron aqueous extracts revealed a clear differentiation of the samples belonging to different quality categories, but a poor separation according to the geographical origin of the spices. On the other hand, linear discriminant analysis based on 8 selected absorbance values, concentrated near 279, 305 and 328nm, allowed a good distinction of the spices coming from different sites. Under severe validation conditions (30% and 50% of saffron samples in the evaluation set), correct predictions were 85 and 83%, respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

New Hydrogels Enriched with Antioxidants from Saffron Crocus Can Find Applications in Wound Treatment and/or Beautification.

PubMed

Zeka, Keti; Ruparelia, Ketan C; Sansone, Claudia; Macchiarelli, Guido; Continenza, Maria Adelaide; Arroo, Randolph R J

2018-01-01

Saffron extracts have a long history of application as skin protectant, possibly due to their ability to scavenge free radicals. In this work, the performance of a hydrogel enriched with antioxidant compounds isolated from saffron crocus (Crocus sativus L.) petals was tested. These hydrogels could be considered as new drug delivery system. Hydrogels are crosslinked polymer networks that absorb large quantities of water but retain the properties of a solid, thus making ideal dressings for sensitive skin. We tested antioxidant-enriched hydrogels on primary mouse fibroblasts. Hydrogels enriched with kaempferol and crocin extracted from saffron petals showed good biocompatibility with in vitro cultured fibroblasts. These new types of hydrogels may find applications in wound treatment and/or beautification. © 2018 S. Karger AG, Basel.

Effects of gamma irradiation and silver nano particles on microbiological characteristics of saffron, using hurdle technology.

PubMed

Hamid Sales, E; Motamedi Sedeh, F; Rajabifar, S

2012-03-01

Saffron, a plant from the Iridaceae family, is the world's most expensive spice. Gamma irradiation and silver nano particles whose uses are gradually increasing worldwide, have positive effects on preventing decay by sterilizing the microorganisms and by improving the safety without compromising the nutritional properties and sensory quality of the foods. In the present study combination effects of gamma irradiation and silver nano particles packaging on the microbial contamination of saffron were considered during storage. A combination of hurdles can ensure stability and microbial safety of foods. For this purpose, saffron samples were packaged by Poly Ethylene films that posses up to 300 ppm nano silver particles as antimicrobial agents and then irradiated in cobalt-60 irradiator (gamma cell PX30, dose rate 0.55 Gry/Sec) to 0, 1, 2,3 and 4 kGy at room temperature. The antimicrobial activities against Total Aerobic Mesophilic Bacteria, Entrobacteriace, Escherichia Coli and Clostridium Perfringines were higher in the irradiated samples, demonstrating the inhibition zone for their growth. Irradiation of the saffron samples packaged by Poly Ethylene films with nano silver particles showed the best results for decreasing microbial contamination at 2 kGy and for Poly Ethylene films without silver nano particles; it was 4 kGy.

Effect of saffron (Crocus sativus L.) on sodium valporate induced cytogenetic and testicular alterations in albino rats

PubMed Central

Zowail, Mohamed E.; Marzouk, Amera M.

2014-01-01

The present study investigated the cytogenetic and testicular damage induced by the antiepileptic drug, sodium valporate (SVP) in albino rats and the effect of saffron aqueous extracts. Treating rats with SVP caused a significant increase in the chromosomal aberrations either structural or numerical and decreased the mitotic index. Besides, animals administered SVP showed DNA damage appeared in the single strand breaks (comet assay). Testis of SVP-treated rats showed many histopathological changes. A significant decrease in seminiferous tubules and their epithelial heights diameters and inhibition of spermatogenesis was recorded. In addition, the number of sperm head abnormalities was increased. Biochemical results revealed an increase in malondialdhyde (MDA) which is lipid peroxidation marker and a significant decrease in the level of serum antioxidant enzyme, catalase (CAT) and reducing antioxidant power (RAP). Animals given SVP and saffron showed an improvement in chromosomal aberrations, mitotic index, DNA damage and testicular alterations caused by SVP. Moreover, MDA decreased and CAT and RAP increased. It is concluded from the present results that the ameliorative effects of saffron extract against SVP-induced cytogenetic and testicular damage in albino rats may be due to the presence of one or more antioxidant components of saffron. PMID:25276476

Effect of saffron (Crocus sativus L.) on sodium valporate induced cytogenetic and testicular alterations in albino rats.

PubMed

Sakr, Saber A; Zowail, Mohamed E; Marzouk, Amera M

2014-09-01

The present study investigated the cytogenetic and testicular damage induced by the antiepileptic drug, sodium valporate (SVP) in albino rats and the effect of saffron aqueous extracts. Treating rats with SVP caused a significant increase in the chromosomal aberrations either structural or numerical and decreased the mitotic index. Besides, animals administered SVP showed DNA damage appeared in the single strand breaks (comet assay). Testis of SVP-treated rats showed many histopathological changes. A significant decrease in seminiferous tubules and their epithelial heights diameters and inhibition of spermatogenesis was recorded. In addition, the number of sperm head abnormalities was increased. Biochemical results revealed an increase in malondialdhyde (MDA) which is lipid peroxidation marker and a significant decrease in the level of serum antioxidant enzyme, catalase (CAT) and reducing antioxidant power (RAP). Animals given SVP and saffron showed an improvement in chromosomal aberrations, mitotic index, DNA damage and testicular alterations caused by SVP. Moreover, MDA decreased and CAT and RAP increased. It is concluded from the present results that the ameliorative effects of saffron extract against SVP-induced cytogenetic and testicular damage in albino rats may be due to the presence of one or more antioxidant components of saffron.

A Systematic Review of Randomized Controlled Trials Examining the Effectiveness of Saffron (Crocus sativus L.) on Psychological and Behavioral Outcomes

PubMed Central

Hausenblas, Heather Ann; Heekin, Kacey; Mutchie, Heather Lee; Anton, Stephen

2017-01-01

Introduction Throughout the past three decades, increased scientific attention has been given to examining saffron’s (Crocus sativus L.) use as a potential therapeutic or preventive agent for a number of health conditions, including cancer, cardiovascular disease, and depression. Saffron has been shown to improve numerous health-related physiological to psychological outcomes. The purpose of this systematic review is to examine and categorize the current state of scientific evidence from randomized controlled trials (RCTs) regarding the efficacy of saffron on psychological and behavioral outcomes. Methods Electronic and non-electronic systematic searches were conducted to identify all relevant human clinical research on saffron. The search strategy was extensive and was designed according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)”. Reference lists of articles that met the inclusion criteria were searched. Only English language studies were reviewed. Results Twelve studies met our inclusion criteria. These studies examined the effects of saffron on psychological/behavioral outcomes with respect to the following health conditions: major depressive disorder (n = 6), premenstrual syndrome (n = 1), sexual dysfunction and infertility (n = 4), and weight loss/snacking behaviors (n = 1). The data from these studies support the efficacy of saffron in improving: depressive symptoms, premenstrual symptoms, sexual function, and satiety. Conclusion Findings from initial clinical trials suggest that saffron can improve the symptoms and effects of depression, premenstrual syndrome, sexual dysfunction and infertility, and excessive snacking behaviors. Larger multi-site clinical trials are needed to extend these preliminary findings. PMID:26165367

Effects of Saffron on Cognition, Anxiety, and Depression in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Double-Blind Placebo-Controlled Trial.

PubMed

Moazen-Zadeh, Ehsan; Abbasi, Seyed Hesameddin; Safi-Aghdam, Hamideh; Shahmansouri, Nazila; Arjmandi-Beglar, Akram; Hajhosseinn Talasaz, Azita; Salehiomran, Abbas; Forghani, Saeedeh; Akhondzadeh, Shahin

2018-04-01

Cognitive decline, depression, and anxiety are among the major concerns in patients undergoing coronary artery bypass grafting (CABG). Crocus sativus L. (saffron) seems to be a promising candidate for treatment of these conditions. In this 12-week, randomized, double-blind, placebo-controlled clinical trial, men and women with on-pump CABG, who had Wechsler Memory Scale (WMS) score >70 and age <70 years, received either saffron capsules (15 mg/twice daily) or placebo. Patients were excluded if they had history of treatment with saffron or acetylcholinesterase inhibitors, comorbid neuropsychiatric disorders, serious medical conditions other than cardiovascular diseases, and hypersensitivity to herbal compounds. The primary outcome was defined as the difference in mean total score changes for WMS-Revised from the baseline to week 12 between the saffron and placebo groups. Secondary outcomes included difference in mean score changes from baseline to endpoint between the two treatment groups for Mini Mental Status Examination and subscales of Hospital Anxiety and Depression Scale ( www.irct.ir ; IRCT201408071556N63). No significant difference was detected in primary or secondary outcomes between the saffron and placebo groups. Also, no significant time × treatment interaction effect was found for any of the scales. The results of this trial do not support the hypothesis of potential benefits of saffron in treatment of CABG-related neuropsychiatric conditions.

Saffron improved depression and reduced homocysteine level in patients with major depression: A Randomized, double-blind study

PubMed Central

Jelodar, Gholamali; Javid, Zahra; Sahraian, Ali; Jelodar, Sina

2018-01-01

Objectives: A correlation between hyperhomocysteinemia, and depression has been reported. Saffron (Crocus sativus) is recommended for treatment of depression; hence, in this study the effect of co-administration of saffron and fluoxetine on plasma homocysteine and depression was evaluated. Material and methods: This was a 4-week randomized and double-blind clinical trial which was conducted from March 2013 to February 2014. In this trial, 40 male and females (20-55 years old) diagnosed with severe depression were selected and following filing the Beck form, were randomly divided into two groups. Experimental group was treated with fluoxetine 20 mg/day and saffron 30 mg /day and the control group received placebo and fluoxetine 20 mg/day for four weeks. Before treatment and at the end of the study, fasting blood samples were collected. For females, blood samples were collected on the third day of their menstrual cycle. Results: A significant reduction of homocysteine levels was observed in both sex in the experimental group compared to before treatment (p<0.04), while no such significant change was observed in the control group. A Beck questionnaire value showed lower level in both groups on the last day of treatment as compared to before treatment. There was no significant difference between the two groups in Beck value neither before nor after treatment. Conclusion: Saffron has beneficial effects on depression and homocysteine level in patients with major depression. PMID:29387573

Is Stigma Internalized? The Longitudinal Impact of Public Stigma on Self-Stigma

ERIC Educational Resources Information Center

Vogel, David L.; Bitman, Rachel L.; Hammer, Joseph H.; Wade, Nathaniel G.

2013-01-01

Stigma is considered an important barrier to seeking mental health services. Two types of stigma exist: public stigma and self-stigma. Theoretically, it has been argued that public stigma leads to the development of self-stigma. However, the empirical support for this assertion is limited to cross-sectional data. Therefore, the goal of this…

Comparison of Crocus sativus L. and imipramine in the treatment of mild to moderate depression: A pilot double-blind randomized trial [ISRCTN45683816

PubMed Central

Akhondzadeh, Shahin; Fallah-Pour, Hasan; Afkham, Khosro; Jamshidi, Amir-Hossein; Khalighi-Cigaroudi, Farahnaz

2004-01-01

Background The morbidity and mortality associated with depression are considerable and continue to increase. Depression currently ranks fourth among the major causes of disability worldwide, after lower respiratory infections, prenatal conditions, and HIV/AIDS. Crocus sativus L. is used to treat depression. Many medicinal plants textbooks refer to this indication whereas there is no evidence-based document. Our objective was to compare the efficacy of stigmas of Crocus sativus (saffron) with imipramine in the treatment of mild to moderate depression in a 6-week pilot double-blind randomized trial. Methods Thirty adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition for major depression based on the structured clinical interview for DSM IV participated in the trial. Patients have a baseline Hamilton Rating Scale for Depression score of at least 18. In this double-blind, single-center trial, patients were randomly assigned to receive capsule of saffron 30 mg/day (TDS) (Group 1) and capsule of imipramine 100 mg/day (TDS) (Group 2) for a 6-week study. Results Saffron at this dose was found to be effective similar to imipramine in the treatment of mild to moderate depression (F = 2.91, d.f. = 1, P = 0.09). In the imipramine group anticholinergic effects such as dry mouth and also sedation were observed more often that was predictable. Conclusion The main overall finding from this study is that saffron may be of therapeutic benefit in the treatment of mild to moderate depression. To the best of our knowledge this is the first clinical trial that supports this indication for saffron. A large-scale trial with placebo control is warranted. PMID:15341662

Rapid authentication of the precious herb saffron by loop-mediated isothermal amplification (LAMP) based on internal transcribed spacer 2 (ITS2) sequence.

PubMed

Zhao, Mingming; Shi, Yuhua; Wu, Lan; Guo, Licheng; Liu, Wei; Xiong, Chao; Yan, Song; Sun, Wei; Chen, Shilin

2016-05-05

Saffron is one of the most expensive species of Chinese herbs and has been subjected to various types of adulteration because of its high price and limited production. The present study introduces a loop-mediated isothermal amplification (LAMP) technique for the differentiation of saffron from its adulterants. This novel technique is sensitive, efficient and simple. Six specific LAMP primers were designed on the basis of the nucleotide sequence of the internal transcribed spacer 2 (ITS2) nuclear ribosomal DNA of Crocus sativus. All LAMP amplifications were performed successfully, and visual detection occurred within 60 min at isothermal conditions of 65 °C. The results indicated that the LAMP primers are accurate and highly specific for the discrimination of saffron from its adulterants. In particular, 10 fg of genomic DNA was determined to be the limit for template accuracy of LAMP in saffron. Thus, the proposed novel, simple, and sensitive LAMP assay is well suited for immediate on-site discrimination of herbal materials. Based on the study, a practical standard operating procedure (SOP) for utilizing the LAMP protocol for herbal authentication is provided.

Rapid authentication of the precious herb saffron by loop-mediated isothermal amplification (LAMP) based on internal transcribed spacer 2 (ITS2) sequence

PubMed Central

Zhao, Mingming; Shi, Yuhua; Wu, Lan; Guo, Licheng; Liu, Wei; Xiong, Chao; Yan, Song; Sun, Wei; Chen, Shilin

2016-01-01

Saffron is one of the most expensive species of Chinese herbs and has been subjected to various types of adulteration because of its high price and limited production. The present study introduces a loop-mediated isothermal amplification (LAMP) technique for the differentiation of saffron from its adulterants. This novel technique is sensitive, efficient and simple. Six specific LAMP primers were designed on the basis of the nucleotide sequence of the internal transcribed spacer 2 (ITS2) nuclear ribosomal DNA of Crocus sativus. All LAMP amplifications were performed successfully, and visual detection occurred within 60 min at isothermal conditions of 65 °C. The results indicated that the LAMP primers are accurate and highly specific for the discrimination of saffron from its adulterants. In particular, 10 fg of genomic DNA was determined to be the limit for template accuracy of LAMP in saffron. Thus, the proposed novel, simple, and sensitive LAMP assay is well suited for immediate on-site discrimination of herbal materials. Based on the study, a practical standard operating procedure (SOP) for utilizing the LAMP protocol for herbal authentication is provided. PMID:27146605

Comparative evaluation of an ISO 3632 method and an HPLC-DAD method for safranal quantity determination in saffron.

PubMed

García-Rodríguez, M Valle; López-Córcoles, Horacio; Alonso, Gonzalo L; Pappas, Christos S; Polissiou, Moschos G; Tarantilis, Petros A

2017-04-15

The aim of this work was a comparison of the ISO 3632 (2011) method and an HPLC-DAD method for safranal quantity determination in saffron. Samples from different origins were analysed by UV-vis according to ISO 3632 (2011) and by HPLC-DAD. Both methods were compared, and there was no correlation between the safranal content obtained by UV-vis and HPLC-DAD. An over-estimation in the UV-vis experiment was observed, which was related to the cis-crocetin esters content, as well as other compounds. The results demonstrated that there was no relationship between ISO quality categories and safranal content using HPLC-DAD. Therefore, HPLC-DAD might be preferable to UV-vis for determining the safranal content and the classification of saffron for commercial purposes. In addition, HPLC-DAD was adequate for determining the three foremost parameters that define the quality of saffron (crocetin esters, picrocrocin and safranal); therefore, this approach could be included in the ISO 3632 method (2011). Copyright © 2016 Elsevier Ltd. All rights reserved.

Situating stigma in stratified reproduction: Abortion stigma and miscarriage stigma as barriers to reproductive healthcare.

PubMed

Bommaraju, Aalap; Kavanaugh, Megan L; Hou, Melody Y; Bessett, Danielle

2016-12-01

To examine whether race and reported history of abortion are associated with abortion stigma and miscarriage stigma, both independently and comparatively. Self-administered surveys with 306 new mothers in Boston and Cincinnati, United States. Abortion stigma perception (ASP); miscarriage stigma perception (MSP); and comparative stigma perception (CSP: abortion stigma perception net of miscarriage stigma perception). Regardless of whether or not they reported having an abortion, white women perceived abortion (ASP) to be more stigmatizing than Black and Latina women. Perceptions of miscarriage stigma (MSP), on the other hand, were dependent on reporting an abortion. Among those who reported an abortion, Black women perceived more stigma from miscarriage than white women, but these responses were flipped for women who did not report abortion. Reporting abortion also influenced our comparative measure (CSP). Among those who did report an abortion, white women perceived more stigma from abortion than miscarriage, while Black and Latina women perceived more stigma from miscarriage than abortion. By measuring abortion stigma in comparison to miscarriage stigma, we can reach a more nuanced understanding of how perceptions of reproductive stigmas are stratified by race and reported reproductive history. Clinicians should be aware that reproductive stigmas do not similarly affect all groups. Stigma from specific reproductive outcomes is more or less salient dependent upon a woman's social position and lived experience. Copyright © 2016 Elsevier B.V. All rights reserved.

Stigma

PubMed Central

Santos, Jussara C.; Barros, Sônia; Santos, Irma M. M.

2016-01-01

In this study, we have surveyed how professionals from multidisciplinary teams at psychosocial care centers (CAPS), in the city of São Paulo, understand the concept of mental illness stigma. The aim of the survey was to characterize the actions developed by the team to overcome stigma and, thus, contribute to develop strategies that incorporate overcoming stigma in the territory. Our objective is to get acquainted to the concepts about stigma shared by the participants. This survey was based on the theory of stigma by Erving Goffman; data were collected through semi-structured interviews with mental health professionals belonging to the CAPS teams. Results indicate that social exclusion is understood as a synonym to stigma, and that proximity of CAPS to society in the territory facilitates social inclusion and the overcoming of the mental illness stigma. PMID:28462343

Mental illness stigma: concepts, consequences, and initiatives to reduce stigma.

PubMed

Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W

2005-12-01

Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. This review aims to clarify the concept of mental illness stigma and discuss consequences for individuals with mental illness. After a conceptual overview of stigma we discuss two leading concepts of mental illness stigma and consequences of stigma, focussing on self-stigma/empowerment and fear of stigma as a barrier to using health services. Finally, we discuss three main strategies to reduce stigma -- protest, education, and contact -- and give examples of current anti-stigma campaigns. Well-designed anti-stigma initiatives will help to diminish negative consequences of mental illness stigma.

Growth dynamics of Saffron cod (Eleginus gracilis) and Arctic cod (Boreogadus saida) in the Northern Bering and Chukchi Seas

NASA Astrophysics Data System (ADS)

Helser, T.; Anderl, D.

2016-02-01

Saffron cod (Eleginus gracilis) and Arctic cod (Boreogadus saida) are two circumpolar gadids that serve as critically important species responsible for energy transfer in Arctic food webs of the northern Bering and Chukchi Seas. To understand the potential effects of sea ice loss and warming temperatures on these species' basic life history, information such as growth is needed. Yet to date, limited effort has been dedicated to the study of their growth dynamics. Based on a large sample of otoliths collected in the first comprehensive ecosystem integrated survey in the northern Bering and Chukchi Seas, procedures were developed to reliably estimate age from otolith microstructure and were used to study the growth dynamics of saffron and Arctic cod. Saffron cod attained larger asymptotic sizes (L∞ = 363 mm) and achieved their maximum size at a faster rate (K = 0.378) than Arctic cod (L∞ = 209 mm; K = 0.312). For both species, regional differences in growth were found (p<0.01). Saffron cod grew to a significantly larger size at age in the northern Bering Sea when compared to the Chukchi Sea, particularly at younger ages. Arctic cod grew to smaller a asymptotic size but at faster rates in the more northerly central (L∞ = 197 mm; K = 0.324) and southern Chukchi Sea (L∞ = 221 mm; K = 0.297) when compared to the northern Bering Sea (L∞ = 266 mm; K = 0.171), suggesting a possible cline in growth rates with more northerly latitudes. A 30 year retrospective comparison of age data indicate that both species exhibited a decline is maximum size accompanied by higher instantaneous rates growth in more recent years.

Growth dynamics of saffron cod (Eleginus gracilis) and Arctic cod (Boreogadus saida) in the Northern Bering and Chukchi Seas

NASA Astrophysics Data System (ADS)

Helser, Thomas E.; Colman, Jamie R.; Anderl, Delsa M.; Kastelle, Craig R.

2017-01-01

Saffron cod (Eleginus gracilis) and Arctic cod (Boreogadus saida) are two circumpolar gadids that serve as critically important species responsible for energy transfer in Arctic food webs of the northern Bering and Chukchi Seas. To understand the potential effects of sea ice loss and warming temperatures on these species' basic life history, information such as growth is needed. Yet to date, limited effort has been dedicated to the study of their growth dynamics. Based on a large sample of otoliths collected in the first comprehensive ecosystem integrated survey in the northern Bering and Chukchi Seas, procedures were developed to reliably estimate age from otolith growth zones and were used to study the growth dynamics of saffron and Arctic cod. Annual growth zone assignment was validated using oxygen isotope signatures in otoliths and otolith morphology analyzed and compared between species. Saffron cod attained larger asymptotic sizes (L∞=363 mm) and achieved their maximum size at a faster rate (K=0.378) than Arctic cod (L∞=209 mm; K=0.312). For both species, regional differences in growth were found (p<0.01). Saffron cod grew to a significantly larger size at age in the northern Bering Sea when compared to the Chukchi Sea, particularly at younger ages. Arctic cod grew to smaller asymptotic size but at faster rates in the more northerly central (L∞=197 mm;K=0.324) and southern Chukchi Sea (L∞=221 mm;K=0.297) when compared to the northern Bering Sea (L∞=266 mm;K=0.171), suggesting a possible cline in growth rates with more northerly latitudes. Comparison of growth to two periods separated by 30 years indicate that both species exhibited a decline in maximum size accompanied by higher instantaneous growth rates in more recent years.

The Efficacy of Crocin of Saffron (Crocus sativus L.) on the Components of Metabolic Syndrome: A Randomized Controlled Clinical Trial

PubMed Central

Kermani, Tayyebe; Kazemi, Toba; Molki, Somayye; Ilkhani, Khadije; Sharifzadeh, Gholamreza; Rajabi, Omid

2017-01-01

Objective: Metabolic syndrome is a set of cardiac risk factors with increased risk of chronic diseases. The aim of this study is to evaluate the efficacy of crocin of saffron on metabolic syndrome. Methods: This double-blind, randomized clinical trial was conducted on metabolic syndrome patients who were randomly assigned to crocin of saffron or control (placebo) groups. The intervention group received 100 mg/day crocin tablets (a constituent of saffron) for 6 weeks. Then, the changes in metabolic syndrome component were compared between two groups. The trial was registered in the Iranian Registry of Clinical Trials. Data were entered to SPSS 15. Chi-square, Fisher's exact, paired t-test, and independent t-test were used to analyze data. P < 0.05 was defined as statistical significant level. Findings: Totally, 48 patients included in the trial (24 intervention and 24 placebo participants). There were significant reductions from baseline measurements in the levels of total cholesterol (P < 0.001) and triglyceride (P = 0.003) after the 6-week crocin administration. However, this decrease in lipid profile was not significant when compared with placebo group. There was no significant change in other laboratory values, blood pressure, and anthropometric measures. Conclusion: The present study indicated that the dose of about 100 mg crocin of saffron was well tolerated and has no complication for 6 weeks of oral administration. However, the dosage used in our study had no effect on metabolic syndrome. Further studies are required to assess this effect with the higher dosages of crocin as well as long time effects of its administration on metabolic syndrome patients. PMID:29417083

Effect of Saffron (Fan Hong Hua) On the Readiness of The Uterine Cervix In Term Pregnancy: A Placebo-Controlled Randomized Trial

PubMed Central

Sadi, Roghaieh; Mohammad-Alizadeh-Charandabi, Sakineh; Mirghafourvand, Mojgan; Javadzadeh, Yousef; Ahmadi-Bonabi, Afkham

2016-01-01

Background Readiness of the cervix is required for successful induction of labor, and there are a number of ways in which this can be achieved. Objectives The aim of the present study was to assess whether taking saffron orally could have an effect on the cervical readiness (primary outcome) and some delivery and neonatal outcomes (secondary outcomes) in women in the stage of term pregnancy. Patients and Methods In this double-blind trial, 50 women with a gestational age of 39 to 41 weeks, no indication of cesarean section, a Bishop’s score of less than 4, who had plan to have vaginal delivery at Shohada hospital of Bonab, Iran were randomized into two groups receiving three 250mg saffron or placebo pills in 24 hours. The readiness of the cervix was assessed using the Bishop’s score. The Mann-Whitney U test was used to compare the scores between the groups. Results There were no significant differences between the groups in terms of the Bishop’s score at the baseline (P = 0.792) and 10-12 hours after starting the intervention (P = 0.159). The Bishop’s score was significantly higher in the saffron group 20 - 24 hours after the intervention was started (P = 0.029) and just after onset of active uterine contractions (P = 0.003). In the saffron group, there was no cesarean section and 1 meconium staining of the fetus, but 3 and 4, respectively, in the placebo group. There was no statistically significant difference between the groups in terms of the timing of the onset of spontaneous active uterine contractions, the duration of the first and second stages of labor, the need for delivery augmentation, and the first and fifth minutes of neonatal Apgar (P > 0.05). No adverse event was reported in any of the groups. Conclusions Saffron can increase the readiness of the cervix in term pregnancies. However, the study limitations do not allow for any definite conclusions for its use in clinical practice, and more research is needed to assess its effect on delivery and

Mental illness stigma and suicidality: the role of public and individual stigma.

PubMed

Oexle, N; Waldmann, T; Staiger, T; Xu, Z; Rüsch, N

2018-04-01

Suicide rates are increased among unemployed individuals and mental illness stigma can contribute to both unemployment and suicidality. Persons with mental illness perceive negative attitudes among the general public and experience discrimination in their everyday life (=public stigma components) potentially leading to self-stigma and anticipated discrimination (=individual stigma components). Previous research found evidence for an association between aspects of mental illness stigma and suicidality, but has not yet clarified the underlying pathways explaining how different stigma components interact and contribute to suicidal ideation. Public and individual stigma components and their association with suicidal ideation were examined among 227 unemployed persons with mental illness. A path model linking public stigma components (experienced discrimination, perceived stigma) with suicidal ideation, mediated by individual stigma components (anticipated discrimination, self-stigma), was examined using structural equation modelling within Mplus. Our sample was equally split in terms of gender, on average 43 years old and about half reported no suicidal ideation during the past 30 days. In bivariate analyses all stigma components were significantly associated with suicidal ideation. In the path model and controlling for symptoms, the association between experienced discrimination and suicidal ideation was fully mediated by anticipated discrimination and self-stigma. Perceived stigma's contribution to suicidal ideation was fully mediated by anticipated discrimination, but not by self-stigma. In general, programmes addressing multiple stigma components seem to be most effective in improving suicide prevention. Besides interventions targeting negative attitudes and discriminating behaviours of the general public, programmes to support persons with mental illness in coping with perceived and experienced stigma could improve suicide prevention. Future studies should test

Elucidation and functional characterization of CsPSY and CsUGT promoters in Crocus sativus L.

PubMed Central

Bhat, Archana; Mishra, Sonal; Kaul, Sanjana

2018-01-01

The dried stigmas of Crocus sativus constitute the saffron, which is considered to be the costliest spice of the world. Saffron is valuable for its constituents, which are mainly apocarotenoids. In order to enhance the production of apocarotenoids, it is imperative to understand the regulation of apocarotenoid biosynthetic pathway. In C. sativus, although the pathway has been elucidated, the information regarding the regulation of the pathwaygenes is scanty. During the present investigation, the characterization of promoters regulating the expression of two important genes i.e. CsPSY and CsUGT was performed. We successfully cloned the promoters of both the genes, which were functionally characterized in Crocus sativus and Nicotiana tabaccum. In silico analysis of the promoters demonstrated the presence of several important cis regulatory elements responding tolight, hormonesand interaction with transcription factors (TFs). Further analysis suggested the regulation of CsPSY promoter by Abscisic acid (ABA) and that of CsUGT by Gibberellic acid (GA). In addition, we also observed ABA and GA mediated modulation in the expression of significant TFs and CsPSY and CsUGT transcripts. Overall, the study addresses issues related to regulation of key genes of apocarotenoid pathway in C.sativus. PMID:29634744

Elucidation and functional characterization of CsPSY and CsUGT promoters in Crocus sativus L.

PubMed

Bhat, Archana; Mishra, Sonal; Kaul, Sanjana; Dhar, Manoj K

2018-01-01

The dried stigmas of Crocus sativus constitute the saffron, which is considered to be the costliest spice of the world. Saffron is valuable for its constituents, which are mainly apocarotenoids. In order to enhance the production of apocarotenoids, it is imperative to understand the regulation of apocarotenoid biosynthetic pathway. In C. sativus, although the pathway has been elucidated, the information regarding the regulation of the pathwaygenes is scanty. During the present investigation, the characterization of promoters regulating the expression of two important genes i.e. CsPSY and CsUGT was performed. We successfully cloned the promoters of both the genes, which were functionally characterized in Crocus sativus and Nicotiana tabaccum. In silico analysis of the promoters demonstrated the presence of several important cis regulatory elements responding tolight, hormonesand interaction with transcription factors (TFs). Further analysis suggested the regulation of CsPSY promoter by Abscisic acid (ABA) and that of CsUGT by Gibberellic acid (GA). In addition, we also observed ABA and GA mediated modulation in the expression of significant TFs and CsPSY and CsUGT transcripts. Overall, the study addresses issues related to regulation of key genes of apocarotenoid pathway in C.sativus.

Measuring weight self-stigma: the weight self-stigma questionnaire.

PubMed

Lillis, Jason; Luoma, Jason B; Levin, Michael E; Hayes, Steven C

2010-05-01

Stigma associated with being overweight or obese is widespread. Given that weight loss is difficult to achieve and maintain, researchers have been calling for interventions that reduce the impact of weight stigma on life functioning. Sound measures that are sensitive to change are needed to help guide and inform intervention studies. This study presents the weight self-stigma questionnaire (WSSQ). The WSSQ has 12 items and is designed for use only with populations of overweight or obese persons. Two samples of participants--one treatment seeking, one nontreatment seeking--were used for validation (N = 169). Results indicate that the WSSQ has good reliability and validity, and contains two distinct subscales-self-devaluation and fear of enacted stigma. The WSSQ could be useful for identifying individuals who may benefit from a stigma reduction intervention and may also help evaluate programs designed to reduce stigma.

Pollen and stigma morphology of some Phaseoleae species (Leguminosae) with different pollinators.

PubMed

Basso-Alves, J P; Agostini, K; Teixeira, S de Pádua

2011-07-01

Pollen transport to a receptive stigma can be facilitated through different pollinators, which submits the pollen to different selection pressures. This study aimed to associate pollen and stigma morphology with zoophily in species of the tribe Phaseoleae. Species of the genera Erythrina, Macroptilium and Mucuna with different pollinators were chosen. Pollen grains and stigmas were examined under light microscopy (anatomy), scanning electronic microscopy (surface analyses) and transmission electronic microscopy (ultrastructure). The three genera differ in terms of pollen wall ornamentation, pollen size, pollen aperture, thickness of the pollen wall, amount of pollenkitt, pollen hydration status and dominant reserves within the pollen grain, while species within each genus are very similar in most studied characteristics. Most of these features lack relationships to pollinator type, especially in Erythrina and Mucuna. Pollen reserves are discussed on a broad scale, according to the occurrence of protein in the pollen of invertebrate- or vertebrate-pollinated species. Some pollen characteristics are more associated to semi-dry stigma requirements. This apical, compact, cuticularised and secretory stigma occurs in all species investigated. We conclude that data on pollen and stigma structure should be included together with those on floral morphology and pollinator behaviour for the establishment of functional pollination classes. © 2010 German Botanical Society and The Royal Botanical Society of the Netherlands.

Self-stigma and affiliate stigma in first-episode psychosis patients and their caregivers.

PubMed

Chen, Emily S M; Chang, Wing Chung; Hui, Christy L M; Chan, Sherry K W; Lee, Edwin Ho Ming; Chen, Eric Y H

2016-09-01

Stigma is a major factor causing delayed help-seeking and poor treatment adherence in patients with psychotic disorders. Previous research has mostly focused on chronic samples and the impact of culturally-relevant variables on both patients' and their caregivers' stigmatization is understudied. This study aimed to examine the relationships between various forms of stigma, "face concern", and clinical characteristics in a group of Chinese first-episode psychosis (FEP) patients and their caregivers. Forty-four Hong Kong Chinese aged 15-54 years presenting with FEP to psychiatric services and their caregivers were recruited. Assessments on self-stigma, affiliate stigma, perceived public stigma, "face concern", symptom severity and subjective quality of life (QoL) were conducted. Self-stigma of FEP patients was correlated with perceived public stigma, "face concern", insight and psychological health of QoL. Multiple regression analysis revealed that perceived public stigma and "face concern" independently predicted self-stigma. Mediation analysis further suggested that "face concern" partially mediated the relationship between perceived public stigma and self-stigma. Caregivers' affiliate stigma was significantly associated with higher levels of stress, and symptoms of depression and anxiety. Affiliate stigma did not correlate with perceived public stigma and "face concern". Our results indicate a critical role of perceived public stigma and fear of losing face in determining self-stigma in Chinese patients with FEP. Caregivers with greater degree of affiliate stigma experience increased stress and emotional distress. Our findings highlight the importance to examine culturally specific factors that may contribute to the development of self-stigma in first-episode populations of different ethnicities.

Saffron and crocin improved appetite, dietary intakes and body composition in patients with coronary artery disease

PubMed Central

Abedimanesh, Nasim; Bathaie, S. Zahra; Abedimanesh, Saeed; Motlagh, Behrooz; Separham, Ahmad; Ostadrahimi, Alireza

2017-01-01

Introduction: Central obesity is an independent risk factor for coronary artery disease (CAD). It can increase cardio-metabolic risks through hypertension, hyperlipidemia and insulin resistance. Saffron and its bioactive compounds (crocin and crocetin) can modify some of metabolic disorders through multiple mechanisms. The aim of this study was to assess the efficacy of saffron and crocin on lipid profile, appetite, dietary intakes, anthropometric indices and body composition in patients with CAD. Methods: This 8 weeks randomized, double-blind, and placebo-controlled trial was conducted on 84 patients with CAD between the ages of 40 and 65 years old. Participants were randomly divided into groups to receive a daily supplement of 30 mg saffron aqueous extract (SAE) or 30 mg crocin or placebo. Appetite, dietary intake, anthropometry, body composition, biochemical analysis were assessed before and after the study. Results: In SAE and crocin group, anthropometric and some body composition variables revealed a pattern of improvement after intervention. Decrease in body mass index (BMI), waist circumference and fat mass values in SAE group was significantly more than crocin group (P < 0.001). There was no significant difference at the end of study in lipid profile parameters. Both SAE and crocin yielded significant decrease in energy and dietary intake mean values (P < 0.001 and P = 0.046), while it remained unchanged in the placebo group, also the appetite decreased significantly in SAE and crocin group (P < 0.001 and P = 0.029, respectively). Conclusion: The results of present study regarding anti-obesity feature of SAE and crocin in patients with CAD was promising. However the SAE was better in appetite suppressing, dietary intake and central obesity reduction. PMID:29391933

Apical dominance in saffron and the involvement of the branching enzymes CCD7 and CCD8 in the control of bud sprouting

PubMed Central

2014-01-01

Background In saffron (Crocus sativus), new corms develop at the base of every shoot developed from the maternal corm, a globular underground storage stem. Since the degree of bud sprouts influences the number and size of new corms, and strigolactones (SLs) suppress growth of pre-formed axillary bud, it was considered appropriate to investigate SL involvement in physiology and molecular biology in saffron. We focused on two of the genes within the SL pathway, CCD7 and CCD8, encoding carotenoid cleavage enzymes required for the production of SLs. Results The CsCCD7 and CsCCD8 genes are the first ones isolated and characterized from a non-grass monocotyledonous plant. CsCCD7 and CsCCD8 expression showed some overlapping, although they were not identical. CsCCD8 was highly expressed in quiescent axillary buds and decapitation dramatically reduced its expression levels, suggesting its involvement in the suppression of axillary bud outgrowth. Furthermore, in vitro experiments showed also the involvement of auxin, cytokinin and jasmonic acid on the sprouting of axillary buds from corms in which the apical bud was removed. In addition, CsCCD8 expression, but not CsCCD7, was higher in the newly developed vascular tissue of axillary buds compared to the vascular tissue of the apical bud. Conclusions We showed that production and transport of auxin in saffron corms could act synergistically with SLs to arrest the outgrowth of the axillary buds, similar to the control of above-ground shoot branching. In addition, jasmonic acid seems to play a prominent role in bud dormancy in saffron. While cytokinins from roots promote bud outgrowth. In addition the expression results of CsCCD8 suggest that SLs could positively regulate procambial activity and the development of new vascular tissues connecting leaves with the mother corm. PMID:24947472

The Stigma Complex

PubMed Central

Pescosolido, Bernice A.; Martin, Jack K.

2016-01-01

Since the beginning of the twenty-first century, research on stigma has continued. Building on conceptual and empirical work, the recent period clarifies new types of stigmas, expansion of measures, identification of new directions, and increasingly complex levels. Standard beliefs have been challenged, the relationship between stigma research and public debates reconsidered, and new scientific foundations for policy and programs suggested. We begin with a summary of the most recent Annual Review articles on stigma, which reminded sociologists of conceptual tools, informed them of developments from academic neighbors, and claimed findings from the early period of “resurgence.” Continued (even accelerated) progress has also revealed a central problem. Terms and measures are often used interchangeably, leading to confusion and decreasing accumulated knowledge. Drawing from this work but focusing on the past 14 years of stigma research (including mental illness, sexual orientation, HIV/AIDS, and race/ethnicity), we provide a theoretical architecture of concepts (e.g., prejudice, experienced/received discrimination), drawn together through a stigma process (i.e., stigmatization), based on four theoretical premises. Many characteristics of the mark (e.g., discredited, concealable) and variants (i.e., stigma types and targets) become the focus of increasingly specific and multidimensional definitions. Drawing from complex and systems science, we propose a stigma complex, a system of interrelated, heterogeneous parts bringing together insights across disciplines to provide a more realistic and complicated sense of the challenge facing research and change efforts. The Framework Integrating Normative Influences on Stigma (FINIS) offers a multilevel approach that can be tailored to stigmatized statuses. Finally, we outline challenges for the next phase of stigma research, with the goal of continuing scientific activity that enhances our understanding of stigma and builds

Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions

PubMed Central

White Hughto, Jaclyn M.; Reisner, Sari L.; Pachankis, John E.

2015-01-01

Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. PMID:26599625

Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions.

PubMed

White Hughto, Jaclyn M; Reisner, Sari L; Pachankis, John E

2015-12-01

Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. This critical review aims to integrate the literature on stigma towards transgender people in the U.S. This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stigma Power

PubMed Central

Link, Bruce G.; Phelan, Jo

2015-01-01

When people have an interest in keeping other people down, in or away, stigma is a resource that allows them to obtain ends they desire. We call this resource “stigma power” and use the term to refer to instances in which stigma processes achieve the aims of stigmatizers with respect to the exploitation, control or exclusion of others. We draw on Bourdieu (1987; 1990) who notes that power is often most effectively deployed when it is hidden or “misrecognized.” To explore the utility of the stigma power concept we examine ways in which the goals of stigmatizers are achieved but hidden in the stigma coping efforts of people with mental illnesses. We developed new self-report measures and administered them to a sample of individuals who have experienced mental illness to test whether results are consistent with the possibility that, in response to negative societal conceptions, the attitudes, beliefs and behaviors of people with psychosis lead them to be concerned with staying in, propelled to stay away and induced to feel downwardly placed –precisely the outcomes stigmatizers might desire. Our introduction of the stigma power concept carries the possibility of seeing stigmatizing circumstances in a new light. PMID:24507908

["StigMa" - Evaluation of a Psychological Therapy Program for Stigma-Management].

PubMed

Schenner, Manuela; Kohlbauer, Daniela; Meise, Ullrich; Haller, Christina; Pixner-Huber, Martina; Stürz, Kristina; Günther, Verena

2018-01-01

The project "Stigma Management - StigMa" aims on the evaluation of an adaptive therapy program for patients with psychiatric illness to help them in managing internalized stigma and self-stigmatization. The patients for this pilot-study were recruited in day-hospitals of pro mente tirol . 26 patients participated in 11 group sessions, following 6 modules: "Education", "Activation of Resources", "Social Network", "Self-Esteem", "Social competence in public places" and "My personal stigma management". The control group consisted of 20 patients who did not participate in StigMa. Pre-post-evaluation was done by the Internalized Stigma of Mental Illness-Scale 1. No significant interaction effects could be observed, although in the treatment group, the burden of perceived discrimination was significantly less pronounced after training than before it. The program, however, was evaluated as being extremely positive by the participants. The program StigMa will be adapted in accordance with the suggestions of the participants and reevaluated taking into consideration methodological optimization. © Georg Thieme Verlag KG Stuttgart · New York.

How Anticipated and Experienced Stigma Can Contribute to Self-Stigma: The Case of Problem Gambling.

PubMed

Hing, Nerilee; Russell, Alex M T

2017-01-01

The degree to which anticipated and experienced public stigma contribute to self-stigma remains open to debate, and little research has been conducted into the self-stigma of problem gambling. This study aimed to examine which aspects of anticipated and experienced stigma (if any) predict the anticipated level of public stigma associated with problem gambling and the degree of self-stigma felt by people experiencing problem gambling. An online survey of 177 Australians experiencing problem gambling examined whether aspects of the public characterization of problem gambling, anticipated reactions to problem gamblers, and experiences of devaluation and discrimination predicted anticipated level of public stigma and self-stigma. The study found that self-stigma increases with expectations that the public applies a range of negative stereotypes to people with gambling problems, holds demeaning and discriminatory attitudes toward them, and considers them to lead highly disrupted lives. These variables directly predicted anticipated level of public stigma and indirectly predicted self-stigma. These findings lend weight to conceptualizations of self-stigma as an internalization of actual or anticipated public stigma. They also highlight the need for stigma reduction efforts, particularly those that lower negative stereotyping and prejudicial attitudes, to improve currently low rates of help-seeking amongst people with gambling problems.

How Anticipated and Experienced Stigma Can Contribute to Self-Stigma: The Case of Problem Gambling

PubMed Central

Hing, Nerilee; Russell, Alex M. T.

2017-01-01

The degree to which anticipated and experienced public stigma contribute to self-stigma remains open to debate, and little research has been conducted into the self-stigma of problem gambling. This study aimed to examine which aspects of anticipated and experienced stigma (if any) predict the anticipated level of public stigma associated with problem gambling and the degree of self-stigma felt by people experiencing problem gambling. An online survey of 177 Australians experiencing problem gambling examined whether aspects of the public characterization of problem gambling, anticipated reactions to problem gamblers, and experiences of devaluation and discrimination predicted anticipated level of public stigma and self-stigma. The study found that self-stigma increases with expectations that the public applies a range of negative stereotypes to people with gambling problems, holds demeaning and discriminatory attitudes toward them, and considers them to lead highly disrupted lives. These variables directly predicted anticipated level of public stigma and indirectly predicted self-stigma. These findings lend weight to conceptualizations of self-stigma as an internalization of actual or anticipated public stigma. They also highlight the need for stigma reduction efforts, particularly those that lower negative stereotyping and prejudicial attitudes, to improve currently low rates of help-seeking amongst people with gambling problems. PMID:28270787

Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses.

PubMed

Gaddis, S Michael; Ramirez, Daniel; Hernandez, Erik L

2018-01-01

Scholars suggest that public mental health stigma operates at a meso-level and is associated with severity of symptoms, disclosure, self-esteem, and treatment-seeking behavior. However, the operationalization of public stigma nearly always comes from an individual-level generalization of what others believe. Using data from over 60,000 students on 75 U.S. college and university campuses between 2009 and 2015, we contextualize public stigma by creating a school-level measure of students' individual-level endorsed mental health treatment stigma. We present multilevel logistic regression models for 21 different dependent variables. We find that even after controlling for individual-level stigma scores, school-level stigma is negatively associated with self-reports of suicidal ideation and self-injury, although not associated with screens for depression or anxiety. Moreover, school-level stigma is negatively associated with medication use, counseling and therapy visits, and to a lesser degree, informal support. We suggest that future research should continue to examine the contextual environment of public stigma, while policymakers may be able to implement changes to significantly reduce stigma at this level. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gender, Self-Stigma, and Public Stigma in Predicting Attitudes toward Psychological Help-Seeking

ERIC Educational Resources Information Center

Topkaya, Nursel

2014-01-01

Using a sample of university students (N = 362), the role of gender and both the self-stigma and public stigma associated with one's decision to seek psychological help in predicting attitudes toward psychological helpseeking were examined. Moreover, gender differences regarding both the self-stigma and the public stigma associated with…

Reexamining epilepsy-associated stigma: validation of the Stigma Scale of Epilepsy in Zambia.

PubMed

Elafros, Melissa A; Bowles, Ryan P; Atadzhanov, Masharip; Mbewe, Edward; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L

2015-06-01

Epilepsy-associated stigma is an important patient-centered outcome, yet quantification remains challenging. Jacoby's 3-item Stigma Scale is commonly used to assess felt stigma among people with epilepsy (PWE) yet has ceiling effects. The Stigma Scale of Epilepsy (SSE) is a 24-item instrument that measures felt stigma among PWE and stigmatizing attitudes among others. If cross-culturally valid, the SSE may elucidate stigma determinants and provide an outcome measure for interventions. We assessed the properties of the SSE in 102 Zambian PWE using exploratory and confirmatory item response theories and compared the latent traits assessed by the SSE to those assessed by Jacoby's Stigma Scale. Differential item functioning based on forced disclosure of epilepsy was examined. The SSE yielded two latent traits--the first reflected difficulties faced by PWE; the second reflected emotions associated with epilepsy. Jacoby's Stigma Scale was associated only with the first latent trait. Forced disclosure was associated with "worry" and "pity" that were associated with the second latent trait. In Zambian PWE, the SSE captured two latent traits. One trait represents feelings associated with epilepsy, which is theorized as a substantial yet unmeasured part of stigma. The SSE performs well across cultures and may more comprehensively assess felt stigma than other instruments. Further validation is required to determine whether the SSE adequately assesses stigmatizing attitudes among people without epilepsy.

The Stigma of Personality Disorders.

PubMed

Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick

2016-01-01

This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma.

Stigma and work.

PubMed

Stuart, Heather

2004-01-01

This paper addresses what is known about workplace stigma and employment inequity for people with mental and emotional problems. For people with serious mental disorders, studies show profound consequences of stigma, including diminished employability, lack of career advancement and poor quality of working life. People with serious mental illnesses are more likely to be unemployed or to be under-employed in inferior positions that are incommensurate with their skills or training. If they return to work following an illness, they often face hostility and reduced responsibilities. The result may be self-stigma and increased disability. Little is yet known about how workplace stigma affects those with less disabling psychological or emotional problems, even though these are likely to be more prevalent in workplace settings. Despite the heavy burden posed by poor mental health in the workplace, there is no regular source of population data relating to workplace stigma, and no evidence base to support the development of best-practice solutions for workplace anti-stigma programs. Suggestions for research are made in light of these gaps.

Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms

PubMed Central

Earnshaw, Valerie A; Smith, Laramie R; Cunningham, Chinazo O; Copenhaver, Michael M

2016-01-01

We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live. PMID:24170015

Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms.

PubMed

Earnshaw, Valerie A; Smith, Laramie R; Cunningham, Chinazo O; Copenhaver, Michael M

2015-08-01

We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live. © The Author(s) 2013.

Disentangling self-stigma: are mental illness and help-seeking self-stigmas different?

PubMed

Tucker, Jeritt R; Hammer, Joseph H; Vogel, David L; Bitman, Rachel L; Wade, Nathaniel G; Maier, Emily J

2013-10-01

Two established but disparate lines of research exist: studies examining the self-stigma associated with mental illness and studies examining the self-stigma associated with seeking psychological help. Whereas some researchers have implicitly treated these 2 constructs as synonymous, others have made the argument that they are theoretically and empirically distinct. To help clarify this debate, we examined in the present investigation the overlap and uniqueness of the self-stigmas associated with mental illness and with seeking psychological help. Data were collected from a sample of college undergraduates experiencing clinical levels of psychological distress (N = 217) and a second sample of community members with a self-reported history of mental illness (N = 324). Confirmatory factor analyses provide strong evidence for the factorial independence of the 2 types of self-stigma. Additionally, results of regression analyses in both samples suggest that the 2 self-stigmas uniquely predict variations in stigma-related constructs (i.e., shame, self-blame, and social inadequacy) and attitudes and intentions to seek help. Implications for researchers and clinicians interested in understanding stigma and enhancing mental health service utilization are discussed.

Antioxidant activity, cytotoxic activity and metabolic profiling of juices obtained from saffron (Crocus sativus L.) floral by-products.

PubMed

Tuberoso, Carlo I G; Rosa, Antonella; Montoro, Paola; Fenu, Maurizio Antonio; Pizza, Cosimo

2016-05-15

Juices obtained from cold-pressed saffron (Crocus sativus L.) floral by-products were evaluated as a potential source of compounds with antioxidant and cytotoxic activities. Floral by-products were split in two batches for extraction 24 and 48h after flower harvesting, respectively. The in vitro anti-oxidant activity of these extracts was tested using the FRAP and DPPH assays, and two biological models of lipid oxidation (activity in preventing cholesterol degradation and protection against Cu(2+)-mediated degradation of the liposomal unsaturated fatty acids). The cytotoxic activity was evaluated using the MTT assay. The results show that extracts obtained 48h post-harvest contained higher levels of total polar phenols and had the highest antioxidant activity in all of the performed assays. The LC-DAD and LC-ESI-(HR)MS(n) metabolic profiles showed high levels of kaempferol derivatives and anthocyanins. This study suggests that juices from saffron floral by-products could potentially be used to develop new products for the food and health industry. Copyright © 2015 Elsevier Ltd. All rights reserved.

The specificity of public stigma: A comparison of suicide and depression-related stigma.

PubMed

Sheehan, Lindsay; Dubke, Rachel; Corrigan, Patrick W

2017-10-01

Each year, approximately 1.3 million Americans survive a suicide attempt. While stigma has been reported by suicide attempt survivors, limited research has examined how suicide stigma may differ from the stigma of mental illness. U.S. adults (n = 440) completed an online survey in which they were randomly assigned to one of four vignettes. Vignettes depicted a target individual with either past depression, past suicide attempt, death by suicide, or no information on suicide or mental illness (control). Participants completed a general measure of stigma, a suicide-specific stigma measure, and were surveyed on the recovery potential of individuals with mental illness and suicide attempt. While the general stigma measure failed to distinguish between groups, significant differences on the suicide stigma scale (SSAS-44) emerged between participants assigned in the depression and suicide conditions, especially for stereotype and prejudice subscales. Across conditions, participants believed that recovery was more realistic for someone described as having a mental illness than it was for someone described as having attempted suicide. These findings suggest that individuals who have attempted suicide are subject to differential stigma content from those with depression. Implications are discussed for combating stigma for suicide attempt survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

Perspectives on perceived stigma and self-stigma in adult male patients with depression.

PubMed

Latalova, Klara; Kamaradova, Dana; Prasko, Jan

2014-01-01

There are two principal types of stigma in mental illness, ie, "public stigma" and "self-stigma". Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is "self-stigma". Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms ("boys don't cry") leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men's feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional.

Reexamining epilepsy-associated stigma: validation of the Stigma Scale of Epilepsy in Zambia

PubMed Central

Bowles, Ryan P.; Atadzhanov, Masharip; Mbewe, Edward; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

2017-01-01

Purpose Epilepsy-associated stigma is an important patient-centered outcome, yet quantification remains challenging. Jacoby’s 3-item Stigma Scale is commonly used to assess felt stigma among people with epilepsy (PWE) yet has ceiling effects. The Stigma Scale of Epilepsy (SSE) is a 24-item instrument that measures felt stigma among PWE and stigmatizing attitudes among others. If cross-culturally valid, the SSE may elucidate stigma determinants and provide an outcome measure for interventions. Methods We assessed the properties of the SSE in 102 Zambian PWE using exploratory and confirmatory item response theories and compared the latent traits assessed by the SSE to those assessed by Jacoby’s Stigma Scale. Differential item functioning based on forced disclosure of epilepsy was examined. Results The SSE yielded two latent traits—the first reflected difficulties faced by PWE; the second reflected emotions associated with epilepsy. Jacoby’s Stigma Scale was associated only with the first latent trait. Forced disclosure was associated with “worry” and “pity” that were associated with the second latent trait. Conclusions In Zambian PWE, the SSE captured two latent traits. One trait represents feelings associated with epilepsy, which is theorized as a substantial yet unmeasured part of stigma. The SSE performs well across cultures and may more comprehensively assess felt stigma than other instruments. Further validation is required to determine whether the SSE adequately assesses stigmatizing attitudes among people without epilepsy. PMID:25416086

Stigma in an Aging Context.

PubMed

Emlet, Charles A

Both the Joint United Nations Program on HIV/AIDS and the US National HIV/AIDS Strategy identify HIV stigma as a barrier to care, a barrier to service access, and deleterious to personal and social well-being. This chapter discusses the topic of HIV stigma from a conceptual basis, including the mechanisms of prejudice and discrimination, and defining anticipated, enacted, and internalized stigma. Stigma is then placed in a historical context of HIV and AIDS, and events exacerbating HIV stigma are discussed. The components of HIV stigma are then applied to the population of older adults (age 50 years and older) who are at-risk of or living with HIV infection. The importance of intersectionality is discussed with regard to race, ethnicity, gender, sexual orientation, gender identity, and in particular, age. Drawing upon the HIV and gerontological literature, the chapter outlines characteristics found to be protective against stigma and placing older adults at greater risk for HIV stigma. Stigma management strategies are outlined and finally, implications of working with older adults related to HIV stigma are provided. © 2017 S. Karger AG, Basel.

Crocins with High Levels of Sugar Conjugation Contribute to the Yellow Colours of Early-Spring Flowering Crocus Tepals

PubMed Central

Rubio Moraga, Angela; Ahrazem, Oussama; Rambla, José Luis; Granell, Antonio; Gómez Gómez, Lourdes

2013-01-01

Crocus sativus is the source of saffron spice, the processed stigma which accumulates glucosylated apocarotenoids known as crocins. Crocins are found in the stigmas of other Crocuses, determining the colourations observed from pale yellow to dark red. By contrast, tepals in Crocus species display a wider diversity of colours which range from purple, blue, yellow to white. In this study, we investigated whether the contribution of crocins to colour extends from stigmas to the tepals of yellow Crocus species. Tepals from seven species were analysed by UPLC-PDA and ESI-Q-TOF-MS/MS revealing for the first time the presence of highly glucosylated crocins in this tissue. β-carotene was found to be the precursor of these crocins and some of them were found to contain rhamnose, never before reported. When crocin profiles from tepals were compared with those from stigmas, clear differences were found, including the presence of new apocarotenoids in stigmas. Furthermore, each species showed a characteristic profile which was not correlated with the phylogenetic relationship among species. While gene expression analysis in tepals of genes involved in carotenoid metabolism showed that phytoene synthase was a key enzyme in apocarotenoid biosynthesis in tepals. Expression of a crocetin glucosyltransferase, previously identified in saffron, was detected in all the samples. The presence of crocins in tepals is compatible with the role of chromophores to attract pollinators. The identification of tepals as new sources of crocins is of special interest given their wide range of applications in medicine, cosmetics and colouring industries. PMID:24058441

Adaptation into Spanish of the Internalised Stigma of Mental Illness scale to assess personal stigma.

PubMed

Bengochea-Seco, Rosario; Arrieta-Rodríguez, Marta; Fernández-Modamio, Mar; Santacoloma-Cabero, Iciar; Gómez de Tojeiro-Roce, Juan; García-Polavieja, Bárbara; Santos-Zorrozúa, Borja; Gil-Sanz, David

2016-03-09

Patients with schizophrenia sometimes internalise social stigma associated to mental illness, and they develop personal stigma. Personal stigma includes self-stigma (internalisation of negative stereotypes), perceived stigma (perception of rejection), and experienced stigma (experiences of discrimination). Personal stigma is linked with a poorer treatment adherence, and worst social functioning. For this reason, it is important to have good measurements of personal stigma. One of the most frequently used measurements is the Internalised Stigma of Mental Illness (ISMI) scale. There is a Spanish version of the scale available, although its psychometric properties have not been studied. The main aim of this study is to analyse the psychometric properties of a new Spanish version of the ISMI scale. The new version was translated as Estigma Interiorizado de Enfermedad Mental (EIEM). Internal consistency and test-retest reliability were calculated in a sample of 69 patients with a diagnosis of schizophrenia or schizoaffective disorder. The rate of patients showing personal stigma was also studied, as well as the relationship between personal stigma and sociodemographic and clinical variables. The adapted version obtained good values of internal consistency and test-retest reliability, for the total score of the scale (0.91 and 0.95 respectively), as well as for the five subscales of the EIEM, except for the Stigma Resistance subscale (Cronbach's alpha 0.42). EIEM is an appropriate measurement tool to assess personal stigma in a Spanish population with severe mental disorder, at least in those with a diagnosis of schizophrenia or schizoaffective disorder. Copyright © 2016. Published by Elsevier España.

Perceptions of Suicide Stigma.

PubMed

Frey, Laura M; Hans, Jason D; Cerel, Julie

2016-03-01

Previous research has failed to examine perceptions of stigma experienced by individuals with a history of suicidal behavior, and few studies have examined how stigma is experienced based on whether it was perceived from treatment providers or social network members. This study examined stigma experienced by individuals with previous suicidal behavior from both treatment providers and individuals in one's social and family networks. Individuals (n = 156) with a lifetime history of suicidal behavior were recruited through the American Association of Suicidology listserv. Respondents reported the highest rates of perceived stigma with a close family member (57.1%) and emergency department personnel (56.6%). Results indicated that individuals with previous suicidal behavior were more likely to experience stigma from non-mental health providers and social network members than from mental health providers. A hierarchical regression model including both source and type of stigma accounted for more variance (R(2) = .14) in depression symptomology than a model (R(2) = .06) with only type of stigma. Prevalence of stigma perceived from social network members was the best predictor of depression symptom severity. These findings highlight the need for future research on how social network members react to suicide disclosure and potential interventions for improving interactions following disclosure.

Medical students and stigma of depression. Part 2. Self-stigma.

PubMed

Suwalska, Julia; Suwalska, Aleksandra; Szczygieł, Marta; Łojko, Dorota

2017-06-18

Up to 30% of medical students suffer from depression. They have better access to healthcare, but still receive appropriate treatment less frequently than people with depression in the general population. Most of them do not seek medical help as depression is perceived as a stigmatizing disorder, which leads to self-stigma and hampers early diagnosis and treatment. Thus, self-stigma means less effective therapy, unfavorable prognosis and relapses. According to the literature, self-stigma results in lowered self-esteem and is a major obstacle in the performance of social roles at work and in personal life. Stigmatization and self-stigma of depression among medical students are also associated with effects in their later professional life: they can lead to long-term consequences in the process of treating their patients in the future. Currently there are no unequivocal research results indicating the most effective ways of reducing stigmatization and self-stigma. It is necessary to educate about the symptoms and treatment of depression and to implement diverse intervention techniques to change behaviors and attitudes as early as possible.

Stigma by Any Other Name.

PubMed

Sheehan, Lindsay; Fominaya, Adam W; Bink, Andrea B; Kraus, Dana J; Schmidt, Anne; Corrigan, Patrick W

2016-12-01

Some advocates argue that the word "stigma" is itself stigmatizing and contributes to further denigration of people with mental illness. This brief report presents results of a nationwide survey comparing terminology related to stigma in regard to mental illness. A total of 340 Amazon Mechanical Turk survey takers read variations of a vignette depicting an individual with schizophrenia and then completed a brief stigma measure. The vignette varied in a single sentence in which three different words-"stigma," "prejudice," and "reactions"-were used to describe coworkers' possible attitudes toward the depicted individual. Stigma ratings did not differ by vignette group. "Reactions" was viewed as significantly less disrespectful than both "stigma" and "prejudice" (p<.001). Further research is needed to support replacing the word "stigma" in public arenas. Current efforts to remove the word may unnecessarily distract advocates and policy makers from the primary mission of erasing stigma.

How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes.

PubMed

Turan, Bulent; Budhwani, Henna; Fazeli, Pariya L; Browning, Wesley R; Raper, James L; Mugavero, Michael J; Turan, Janet M

2017-01-01

Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes-information that can be used to shape interventions.

How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes

PubMed Central

Budhwani, Henna; Fazeli, Pariya L.; Browning, Wesley R.; Raper, James L.; Mugavero, Michael J.; Turan, Janet M.

2016-01-01

Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes—information that can be used to shape interventions. PMID:27272742

The Self-Stigma Process in Criminal Offenders

PubMed Central

Moore, Kelly E.; Tangney, June P.; Stuewig, Jeffrey B.

2016-01-01

Upon conviction, individuals receive the stigmatizing label “criminal offender.” Existing stereotypes about criminal offenders may be integrated into the self-concept, a phenomenon known as self-stigma. In many stigmatized groups, self-stigma is a robust predictor of poor functioning (Livingston & Boyd, 2010; Schomerus et al., 2011). However, little is known about how self-stigma occurs (Corrigan et al., 2006), and there has been limited research with criminal offenders. This study examines a theoretical model of self-stigma in which perceived stigma leads to stereotype agreement, internalized stigma, and then to anticipated stigma. A sample of 203 male jail inmates completed assessments of these constructs just prior to release. Results show a significant indirect path from perceived stigma to stereotype agreement to internalized stigma, but not to anticipated stigma. However, perceived stigma was directly related to anticipated stigma. In conclusion, perceived stigma affects the self through two processes: it indirectly leads to internalized stigma through one avenue, and directly leads to anticipated stigma through a separate avenue. Race, criminal identity, and attitudes toward criminals were examined as moderators. PMID:27761521

Public stigma and self-stigma: differential association with attitudes toward formal and informal help seeking.

PubMed

Pattyn, Elise; Verhaeghe, Mieke; Sercu, Charlotte; Bracke, Piet

2014-02-01

Individuals in need of psychiatric treatment often avoid seeking help because of stigma. This study examined the impact of two stigma dimensions on help-seeking attitudes. Perceived public stigma refers to discrimination and devaluation by others, and anticipated self-stigma refers to internalization of negative stereotypes about people who seek help. Data were from the 2009 Stigma in a Global Context-Belgian Mental Health Study, in which face-to-face interviews were conducted with a representative sample of the general Belgian population. The study reported here included 728 respondents who received a vignette depicting major depression or schizophrenia. Perceived public stigma and anticipated self-stigma were measured with validated instruments. Respondents' attitudes toward help seeking were measured by the importance they assigned to care from formal and informal providers: general practitioners, psychiatrists, psychologists, family members, or friends. Multiple linear regression models were estimated. Respondents with higher levels of anticipated self-stigma attached less importance to care provided by general practitioners or psychiatrists, and those with higher levels of perceived public stigma rated informal help seeking as less important. The gender and the ethnicity of the person and respondents' sociodemographic characteristics had relatively little effect on help-seeking attitudes. Anticipated self-stigma and perceived public stigma appeared to have a differential impact on attitudes toward formal and informal help seeking. Internalization of negative stereotypes was negatively associated with the perceived importance of care from medical providers (general practitioners and psychiatrists). Awareness of stereotypes held by others deterred respondents from acknowledging the importance of informal care.

Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma.

PubMed

Earnshaw, Valerie; Smith, Laramie; Copenhaver, Michael

2013-02-01

Experiences of stigma from others among people with a history of drug addiction are understudied in comparison to the strength of stigma associated with drug addiction. Work that has studied these experiences has primarily focused on stigma experienced from healthcare workers specifically even though stigma is often experienced from other sources as well. Because stigma has important implications for the mental health and recovery efforts of people in treatment, it is critical to better understand these experiences of stigma. Therefore, we characterize drug addiction stigma from multiple sources using qualitative methodology to advance understandings of how drug addiction stigma is experienced among methadone maintenance therapy patients and from whom. Results demonstrate that methadone maintenance therapy patients experience prejudice, stereotypes, and discrimination from friends and family, coworkers and employers, healthcare workers, and others. Discussion highlights similarities and differences in stigma experienced from these sources.

Dual Perspectives On Stigma: Reports of Experienced and Enacted Stigma by Those Affected and Unaffected by Podoconiosis

PubMed Central

Ayode, Desta; Tora, Abebayehu; Farrell, David; Tadele, Getnet; Davey, Gail; McBride, Colleen M.

2016-01-01

Background: Disease-related stigma is a public health concern steadily gaining global attention. Evidence consistently shows that an individual’s attribution of disease cause can prompt or justify interpersonal stigma. However, few studies have explored causal beliefs about inherited disease and their influence on stigmatising behaviours in low and middle income countries. Design and methods: The study was conducted in 2013, in six communities in Wolaita zone, Southern Ethiopia. A total of 1800 respondents took part in the study, 600 were affected by an inherited disease and 1200 were unaffected neighbours. Two versions of the interviewer-administered survey were created, with measures assessed in parallel on experienced stigma for the affected and enacted stigma for unaffected respondents. Results: Mean levels of enacted stigma reported by unaffected respondents were slightly lower (2.0, SD=0.7) than experienced stigma reported by affected respondents [2.2 (standard deviation=1.1)]. Beliefs that podoconiosis was hereditary were significantly and positively associated with levels of enacted stigma reported by unaffected respondents and experienced stigma reported by affected respondents (P<0.001). There was no association of reported levels of stigma experienced by affected respondents with levels of enacted stigma reported by the neighbouring unaffected respondents. Males consistently reported significantly lower levels of experienced and enacted stigma than females, P<0.0001. Conclusions: If stigma reduction interventions are to be successful, culturally tailored, gender inclusive and innovative health education programs are required, directed at the general community as well as individuals affected by inherited diseases. Significance for public health Disease-related stigma is a public health concern steadily gaining global attention. In this report, we evaluated dual perspectives of stigma, that is, we compared reports of stigma experienced by families

Vicious circle of perceived stigma, enacted stigma and depressive symptoms among children affected by HIV/AIDS in China.

PubMed

Chi, Peilian; Li, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang

2014-06-01

Previous research has found a deleterious impact of stigma on the mental health of children affected by HIV/AIDS. Little is known about the longitudinal relationship of stigma and children's mental health. This study explores the longitudinal reciprocal effects of depressive symptoms and stigma, specifically enacted stigma and perceived stigma, among children affected by HIV/AIDS aged 6-12. Longitudinal data were collected from 272 children orphaned by AIDS and 249 children of HIV-positive parents in rural China. Cross-lagged panel analysis was conducted in the study. Results showed that the autoregressive effects were stable for depressive symptoms, perceived stigma and enacted stigma suggesting the substantially stable individual differences over time. The cross-lagged effects indicated a vicious circle among the three variables in an order of enacted stigma → depressive symptom → perceived stigma → enacted stigma. The possibility of employing equal constraints on cross-lagged paths suggested that the cross-lagged effects were repeatable over time. The dynamic interplay of enacted stigma, perceived stigma and depressive symptoms suggests the need of a multilevel intervention in stigma reduction programming to promote mental health of children affected by HIV/AIDS.

Rethinking theoretical approaches to stigma: a Framework Integrating Normative Influences on Stigma (FINIS).

PubMed

Pescosolido, Bernice A; Martin, Jack K; Lang, Annie; Olafsdottir, Sigrun

2008-08-01

A resurgence of research and policy efforts on stigma both facilitates and forces a reconsideration of the levels and types of factors that shape reactions to persons with conditions that engender prejudice and discrimination. Focusing on the case of mental illness but drawing from theories and studies of stigma across the social sciences, we propose a framework that brings together theoretical insights from micro, meso and macro level research: Framework Integrating Normative Influences on Stigma (FINIS) starts with Goffman's notion that understanding stigma requires a language of social relationships, but acknowledges that individuals do not come to social interaction devoid of affect and motivation. Further, all social interactions take place in a context in which organizations, media and larger cultures structure normative expectations which create the possibility of marking "difference". Labelling theory, social network theory, the limited capacity model of media influence, the social psychology of prejudice and discrimination, and theories of the welfare state all contribute to an understanding of the complex web of expectations shaping stigma. FINIS offers the potential to build a broad-based scientific foundation based on understanding the effects of stigma on the lives of persons with mental illness, the resources devoted to the organizations and families who care for them, and policies and programs designed to combat stigma. We end by discussing the clear implications this framework holds for stigma reduction, even in the face of conflicting results.

Public stigma and attitudes toward psychological help-seeking in the United Arab Emirates: The mediational role of self-stigma.

PubMed

Vally, Zahir; Cody, Brettjet L; Albloshi, Maryam A; Alsheraifi, Safeya N M

2018-04-17

Scholars argue that public stigma is predictive of self-stigma, and self-stigma is a primary predictor of attitudes toward seeking psychological help (ATPH). This assertion remains undetermined outside of the United States. This study examines a potential mediational model in which internalized stigma was hypothesized to mediate the relationship between public stigma and ATPH using a sample in the United Arab Emirates. Cross-sectional, correlational design; 114 students completed measures of public stigma, self-stigma, and ATPH. Full mediation occurred. The sample exhibited high levels of both public stigma and self-stigma. Psychology students manifested diminished levels of stigma and more favorable ATPH. Results are discussed in relation to the prevalent cultural and contextual factors. Stigma reduction campaigns in this locale should target internalized stigma and its associated socio-cultural nuances. © 2018 Wiley Periodicals, Inc.

Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma

PubMed Central

Smith, Laramie; Copenhaver, Michael

2013-01-01

Experiences of stigma from others among people with a history of drug addiction are understudied in comparison to the strength of stigma associated with drug addiction. Work that has studied these experiences has primarily focused on stigma experienced from healthcare workers specifically even though stigma is often experienced from other sources as well. Because stigma has important implications for the mental health and recovery efforts of people in treatment, it is critical to better understand these experiences of stigma. Therefore, we characterize drug addiction stigma from multiple sources using qualitative methodology to advance understandings of how drug addiction stigma is experienced among methadone maintenance therapy patients and from whom. Results demonstrate that methadone maintenance therapy patients experience prejudice, stereotypes, and discrimination from friends and family, coworkers and employers, healthcare workers, and others. Discussion highlights similarities and differences in stigma experienced from these sources. PMID:23956702

From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma.

PubMed

Quinn, Diane M; Williams, Michelle K; Weisz, Bradley M

2015-06-01

Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future and how anticipation of stigma in turn predicts greater stigma internalization. Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. Correlational analyses indicated that more experiences of discrimination due to one's mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. Experiences of discrimination over one's lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma. (c) 2015 APA, all rights reserved).

Stigma, HIV and health: a qualitative synthesis.

PubMed

Chambers, Lori A; Rueda, Sergio; Baker, D Nico; Wilson, Michael G; Deutsch, Rachel; Raeifar, Elmira; Rourke, Sean B

2015-09-03

HIV-related stigma continues to negatively impact the health and well-being of people living with HIV, with deleterious effects on their care, treatment and quality of life. A growing body of qualitative research has documented the relationship between HIV-related stigma and health. This review aims to synthesize qualitative evidence that explored the intersections of stigma and health for people with HIV. A thematic summary was conducted that was guided by the qualitative metasummary technique developed by Sandelowski and Barraso. Literature searches yielded 8,622 references of which 55 qualitative studies were identified that illustrated HIV-related stigma in the context of health. The metasummary classified qualitative findings into three overarching categories: conceptualizing stigma which identified key dimensions of HIV-related stigma; experiencing stigma which highlighted experiences of stigma in the health context, and managing stigma which described ways in which stigma is avoided or addressed. To better illustrate these connections, the qualitative literature was summarized into the following themes: stigma within health care settings, the role of stigma in caring for one's health, and strategies to address HIV-related stigma in the health context. A number of health care practices were identified--some rooted in institutional practices, others shaped by personal perceptions held by practitioners--that could be stigmatizing or discriminatory towards people with HIV. There existed interconnections between enacted stigma and felt stigma that influenced health care utilization, treatment adherence, and overall health and well-being of people with HIV. Intersectional stigma also emerged as instrumental in the stigma experiences of people living with HIV. A number of strategies to address stigma were identified including social support, education, self-efficacy, resilience activities, and advocacy. This review of the qualitative evidence indicates that HIV

Effects of Cinnamon, Cardamom, Saffron, and Ginger Consumption on Markers of Glycemic Control, Lipid Profile, Oxidative Stress, and Inflammation in Type 2 Diabetes Patients.

PubMed

Azimi, Paria; Ghiasvand, Reza; Feizi, Awat; Hariri, Mitra; Abbasi, Behnoud

2014-01-01

Type 2 diabetes (T2D) may be caused by elevated oxidative stress, inflammation, and hyperglycemia. The phytochemicals in several herbal medicines are reported to effectively improve diabetes and to ameliorate diabetic complications. The aim of the present study was to determine the effects of cinnamon, cardamom, saffron, and ginger as supplementary remedies in T2D. This randomized controlled, clinical trial included 204 T2D patients. The participants were randomly assigned to four intervention groups receiving 3 glasses of black tea and either 3 g cardamom, or cinnamon, or ginger, or 1 g saffron and one control group which consumed only 3 tea glasses without any herbal medicine for 8 weeks. Markers of inflammation, oxidative stress, fasting blood sugar, lipid profile, and anthropometric measures were evaluated at baseline and after 8 weeks of intervention. After 8 weeks of intervention, cinnamon, cardamom, ginger, and saffron consumption had significant effects on total cholesterol, LDL, and HDL levels (p < 0.05) compared with controls. However, the herbal products did not have significant effects on measures of glycemic control, anthropometry, inflammation, and oxidative stress. In within-group comparisons only, cinnamon intake significantly decreased fasting blood sugar (FBS). The herbal remedies examined had significantly beneficial effects on cholesterol, but not on measures of glycemic control, oxidative stress, and inflammation. Based on the contradictory results reported in the literature, the effects of herbal medicine in diabetic patients should undergo further detailed investigation.

Stigma and Stigma by Association in Perceptions of Straight Allies

ERIC Educational Resources Information Center

Goldstein, Susan B.

2017-01-01

As evidence builds for straight allies' contributions to battling sexual prejudice, barriers to assuming this role must be identified and dismantled. This study investigated stigma and stigma by association in perceptions of straight allies in a college population. Adjective rating items were completed by 505 participants who identified as…

From Discrimination to Internalized Mental Illness Stigma: The Mediating Roles of Anticipated Discrimination and Anticipated Stigma

PubMed Central

Quinn, Diane M.; Williams, Michelle K.; Weisz, Bradley M.

2015-01-01

Objective Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future, and how anticipation of stigma, in turn predicts greater stigma internalization. Method Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. Results Correlational analyses indicated that more experiences of discrimination due to one’s mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. Conclusion and Implications for Practice Experiences of discrimination over the lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma. PMID:25844910

Migrants and HIV stigma: findings from the Stigma Index Study (UK).

PubMed

Chinouya, Martha; Hildreth, Anthony; Goodall, Deborah; Aspinall, Peter; Hudson, Alistair

2017-01-01

This paper is based on data collected in 2009 for the international Stigma Index Study which measured the experiences of stigma among participants living with HIV in the UK. Data were collected using a self-completed survey questionnaire and focus group discussions. Quantitative data were analysed using SPSS, while qualitative data were subjected to thematic analysis. The Stigma Index attempts to establish a baseline for documenting the experience of stigma and discrimination by people living with HIV while also acting as an advocacy tool whose power lay in the involvement of people living with HIV in the design of study instruments and data collection. Participants were recruited through collaborations with a broad range of UK HIV support organisations. The ethics protocols used were those described in the Stigma Index guidebook. A total of 867 people living with HIV took part, of whom 276 described themselves as 'immigrants'. Most of this 'migrant' subsample (70%) was women. Nearly, all (91%) identified as heterosexual, while 9% were attracted to someone of the same sex as them. Socioeconomic deprivation was a key theme and they reported other stigmatised chronic conditions in addition to HIV. It is not possible to ascertain from the questionnaire, the migrants' countries of origin and length of stay in the UK. Control of information about HIV was critically managed, with respect to family and partners. Felt stigma increased anxieties about personal safety, particularly among men. Strategies for safeguarding against the negative impact of stigma included avoiding social gatherings, intimacy, and clinical and HIV social care settings. Most participants were unaware of policies and declarations that protected them as persons living with HIV. Specific recommendations include creating awareness about rights as enshrined in various legal frameworks that protect the right of people living with HIV, which has been reconfigured as a 'disability'. © 2014 John Wiley

Felt and Enacted Stigma Among HIV/HCV-Coinfected Adults: The Impact of Stigma Layering

PubMed Central

Lekas, Helen-Maria; Siegel, Karolynn; Leider, Jason

2015-01-01

The realization that many persons with HIV/AIDS are subjected to multiple layers of stigmatization because they belong to socially deviant and disenfranchised groups (e.g., injection drug users, racial/ethnic and sexual minorities) accounts for an increasing interest in the phenomenon of stigma layering. The stigma associated with HCV has also been conceptualized as layered. However, researchers have overlooked the fact that HCV adds a layer to the HIV stigma and vice versa. Qualitative interviews with 132 HIV/HCV coinfected patients were analyzed to explore how they experience the two layers of stigma. Most participants hierarchically ordered the stigmas associated with each disease and regarded HIV as the more stigmatizing of the two. A small number perceived HIV and HCV as equally stigmatizing. The impact of the hierarchical and non-hierarchical ordering of the two stigmas on coinfected patients’ felt and enacted stigmatization is explored and implications for interventions are discussed. PMID:21498828

Enacted Sexual Stigma, Stigma Consciousness, and Subjective Happiness Scale Adaptation: A Two-Country Study.

PubMed

Strizzi, Jenna; Fernández-Agis, Inmaculada; Parrón-Carreño, Tesifon; Alarcón-Rodríguez, Raquel

2016-01-01

Violence against people due to their sexual orientation is a phenomenon that exists within a framework of sexual stigma and sexual prejudice that can result in enacted stigma. The present study primarily aimed to validate the Stigma Consciousness Questionnaire (SCQ) and the Subjective Happiness Scale (SHS; for lesbian, gay, and bisexual [LGB] populations) in the Spanish context by using samples from two countries (Spain [N = 157] and the United States [N = 83]). Also, to examine how the construct of stigma consciousness correlates with anti-LGBQ (anti-lesbian, gay, bisexual, and queer) hate crime victimization and violent incidents, as well as examine whether the former influences subjective happiness. The population from the United States reported higher stigma consciousness and received more anti-LGBQ threats and insults. Hate crime victimization was the same across the two samples and positively correlated with violent incidents in both samples. Subjective happiness was negatively correlated with SCQ, although its subscales it did not correlate with enacted stigma measures. © The Author(s) 2014.

Polyamide as an efficient sorbent for simultaneous interface-free determination of three Sudan dyes in saffron and urine using high-performance liquid chromatography-ultra violet detection.

PubMed

Saeidi, Iman; Barfi, Behruz; Payrovi, Moazameh; Feizy, Javid; Sheibani, Hojat A; Miri, Mina; Ghollasi Moud, Farahnaz

2015-01-01

With polyamide (PA) as an efficient sorbent for solid phase extraction (SPE) of Sudan dyes II, III and Red 7B from saffron and urine, their determination by HPLC was performed. The optimum conditions for SPE were achieved using 7 mL methanol/water (1:9, v/v, pH 7) as the washing solvent and 3 mL tetrahydrofuran for elution. Good clean-up and high (above 90%) recoveries were observed for all the analytes. The optimized mobile phase composition for HPLC analysis of these compounds was methanol-water (70:30, v/v). The SPE parameters, such as the maximum loading capacity and breakthrough volume, were also determined for each analyte. The limits of detection (LODs), limits of quantification (LOQs), linear ranges and recoveries for the analytes were 4.6-6.6 microg/L, 13.0-19.8 microg/L, 13.0-5000 microg/L (r2>0.99) and 92.5%-113.4%, respectively. The precisions (RSDs) of the overall analytical procedure, estimated by five replicate measurements for Sudan II, III and Red 7B in saffron and urine samples were 2.3%, 1.8% and 3.6%, respectively. The developed method is simple and successful in the application to the determination of Sudan dyes in saffron and urine samples with HPLC coupled with UV detection.

How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model.

PubMed

Jennings, Kristen S; Cheung, Janelle H; Britt, Thomas W; Goguen, Kandice N; Jeffirs, Stephanie M; Peasley, Allison L; Lee, Abigail C

2015-06-01

Many college students may experience mental health problems but do not seek treatment from mental health professionals. The present study examined how perceived stigma and self-stigma toward seeking mental health treatment, as well as perceptions of self-reliance for coping with mental health problems, relate to college student treatment-seeking. In total, 246 students completed a self-report survey that included measures of perceived stigma and self-stigma for treatment-seeking, self-reliance for addressing mental health concerns, self-reported mental health problems, symptoms of depression and alcohol-related problems, attitudes toward treatment-seeking, and treatment-seeking behavior. Regression analyses revealed that higher perceived stigma, self-stigma, and self-reliance were all related to a more negative attitude toward treatment-seeking. In a 3-path mediation model, bootstrapping results indicated an indirect effect where perceived stigma was related to attitude toward treatment-seeking and treatment-seeking behaviors through self-stigma and self-reliance. Specifically, higher perceived stigma was related to higher self-stigma, higher self-stigma was related to higher self-reliance, and higher self-reliance was associated with a more negative attitude toward treatment-seeking in the overall sample, and a decreased probability of having sought treatment among those who screened positive for a mental health problem. Perceived stigma may influence whether or not college students seek treatment for mental health problems by potentially increasing stigmatizing attitudes toward themselves and increasing preferences for handling problems on their own. Researchers and practitioners are recommended to seek a better understanding of the complex treatment barriers to reduce stigma and facilitate treatment-seeking. (c) 2015 APA, all rights reserved).

Vicious Circle of Perceived Stigma, Enacted Stigma and Depressive Symptoms among Children affected by HIV/AIDS in China

PubMed Central

Chi, Peilian; Li, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang

2013-01-01

Previous research has found a deleterious impact of stigma on the mental health of children affected by HIV/AIDS. Little is known about the longitudinal relationship of stigma and children’s mental health. This study explores the longitudinal reciprocal effects of depressive symptoms and stigma, specifically enacted stigma and perceived stigma, among children affected by HIV/AIDS aged 6 to 12. Longitudinal data were collected from 272 children orphaned by AIDS and 249 children of HIV-positive parents in rural China. Cross-lagged panel analysis was conducted in the study. Results showed that the autoregressive effects were stable for depressive symptoms, perceived stigma and enacted stigma suggesting the substantially stable individual differences over time. The cross-lagged effects indicated a vicious circle among the three variables in an order of enacted stigma→depressive symptom→perceived stigma→enacted stigma. The possibility of employing equal constraints on cross-lagged paths suggested that the cross-lagged effects were repeatable over time. The dynamic interplay of enacted stigma, perceived stigma and depressive symptoms suggests the need of a multilevel intervention in stigma reduction programming to promote mental health of children affected by HIV/AIDS. PMID:24158487

Stigma- and non-stigma-related treatment barriers to mental healthcare reported by service users and caregivers.

PubMed

Dockery, Lisa; Jeffery, Debra; Schauman, Oliver; Williams, Paul; Farrelly, Simone; Bonnington, Oliver; Gabbidon, Jheanell; Lassman, Francesca; Szmukler, George; Thornicroft, Graham; Clement, Sarah

2015-08-30

Delayed treatment seeking for people experiencing symptoms of mental illness is common despite available mental healthcare. Poor outcomes are associated with untreated mental illness and caregivers may eventually need to seek help on the service user's behalf. More attention has recently focused on the role of stigma in delayed treatment seeking. This study aimed to establish the frequency of stigma- and non-stigma-related treatment barriers reported by 202 service users and 80 caregivers; to compare treatment barriers reported by service users and caregivers; and to investigate demographic predictors of reporting stigma-related treatment barriers. The profile of treatment barriers differed between service users and caregivers. Service users were more likely to report stigma-related treatment barriers than caregivers across all stigma-related items. Service users who were female, had a diagnosis of schizophrenia or with GCSEs (UK qualifications usually obtained at age 16) were significantly more likely to report stigma-related treatment barriers. Caregivers who were female or of Black ethnicities were significantly more likely to report stigma-related treatment barriers. Multifaceted approaches are needed to reduce barriers to treatment seeking for both service users and caregivers, with anti-stigma interventions being of particular importance for the former group. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Ending self-stigma: pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses.

PubMed

Lucksted, Alicia; Drapalski, Amy; Calmes, Christine; Forbes, Courtney; DeForge, Bruce; Boyd, Jennifer

2011-01-01

This study evaluated "Ending Self-Stigma" (ESS), a structured 9-session group intervention to help people with serious mental illnesses reduce internalized stigma. Participants from two Veterans Administration mental health sites were assessed before and after the intervention regarding their levels of internalized stigma, empowerment, recovery orientation, perceived social support, and beliefs about societal stigma. Internalized stigma significantly decreased, and perceived social support and recovery orientation significantly increased. "Ending Self-Stigma" is the first of its kind and may be a valuable intervention for reducing internalized stigma among people with serious mental illnesses, suitable for both professionally-delivered psychiatric rehabilitation programs and consumer-led programs and services.

Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma

ERIC Educational Resources Information Center

Earnshaw, Valerie; Smith, Laramie; Copenhaver, Michael

2013-01-01

Experiences of stigma from others among people with a history of drug addiction are understudied in comparison to the strength of stigma associated with drug addiction. Work that has studied these experiences has primarily focused on stigma experienced from healthcare workers specifically even though stigma is often experienced from other sources…

Standardized measures for substance use stigma.

PubMed

Brown, Seth A

2011-07-01

Despite indications that the stigma associated with substance use is high and may play a role in discouraging treatment participation, there is limited research in this area and only a few psychometrically sound measures of substance use stigma exist. The purpose of this study was to formulate and evaluate the psychometric properties of three substance use stigma measures. College students (N=565) completed three measures of substance use stigma that were modified from three established measures of mental illness stigma. Two of the three modified measures (Social Distance Scale for Substance Users and Affect Scale for Substance Users) emerged as having acceptable psychometric properties, whereas one modified measure (Dangerousness Scale for Substance Users) had inadequate psychometric properties. In regard to sex differences, women had significantly higher substance use stigma on the two psychometrically sound measures (p<.01). Perhaps, with standardized measures, there can be greater progress towards better understanding the mechanisms leading to high levels of substance use stigma and ultimately address failures to seek out treatment due to stigma. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The Stigma of Mental Illness

ERIC Educational Resources Information Center

Overton, Stacy L.; Medina, Sondra L.

2008-01-01

Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

Predictors of Generalized Anxiety Disorder stigma.

PubMed

Batterham, Philip J; Griffiths, Kathleen M; Barney, Lisa J; Parsons, Alison

2013-04-30

The stigma associated with mental illness can lead to a range of negative outcomes, including delaying or avoiding help seeking. Identifying the characteristics of people who are more likely to hold stigmatizing attitudes enables the development of targeted stigma reduction programs. However, no previous research has systematically examined the predictors of anxiety stigma. This study used the Generalized Anxiety Stigma Scale (GASS) to assess the predictors of personal stigma and perceived stigma associated with Generalized Anxiety Disorder. A community sample of 617 Australian adults completed a survey that included the GASS, the Depression Stigma Scale, exposure to anxiety disorders, emotional distress and a range of demographic characteristics. Linear regression models indicated that women, people with greater exposure to anxiety disorders and people reporting a previous anxiety diagnosis had lower personal stigma toward anxiety. Higher exposure to anxiety disorders and rurality were significantly associated with higher perceived anxiety stigma. Results also suggested that respondents who had only been exposed to anxiety disorders through the media tended to be no more stigmatizing than respondents who had direct contact with people with an anxiety disorder. Media campaigns may be an effective vehicle for decreasing stigmatizing views in the community. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Infectious Disease Stigmas: Maladaptive in Modern Society

PubMed Central

Smith, Rachel A.; Hughes, David

2014-01-01

At multiple times in human history people have asked if there are good stigmas. Is there some useful function stigmas serve in the context of our evolutionary history; is stigma adaptive? This essay discusses stigmas as a group-selection strategy and the human context in which stigmas likely appeared. The next section explores how human patterns have changed in modern society and the consequences for infectious disease (ID) stigmas in the modern age. The concluding section suggests that while social-living species may be particularly apt to create and communicate ID stigmas and enact ID-related stigmatization, such stigma-related processes no longer function to protect human communities. Stigmas do not increase the ability of modern societies to survive infectious diseases, but in fact may be important drivers of problematic disease dynamics and act as catalysts for failures in protecting public health. PMID:25477728

Rethinking Theoretical Approaches to Stigma

PubMed Central

Martin, Jack K; Lang, Annie; Olafsdottir, Sigrun

2008-01-01

A resurgence of research and policy efforts on stigma both facilitates and forces a reconsideration of the levels and types of factors that shape reactions to persons with conditions that engender prejudice and discrimination. Focusing on the case of mental illness but drawing from theories and studies of stigma across the social sciences, we propose a framework that brings together theoretical insights from micro, meso and macro level research: Framework Integrating Normative Influences on Stigma (FINIS) starts with Goffman’s notion that understanding stigma requires a language of social relationships, but acknowledges that individuals do not come to social interaction devoid of affect and motivation. Further, all social interactions take place in a context in which organizations, media and larger cultures structure normative expectations which create the possibility of marking “difference”. Labelling theory, social network theory, the limited capacity model of media influence, the social psychology of prejudice and discrimination, and theories of the welfare state all contribute to an understanding of the complex web of expectations shaping stigma. FINIS offers the potential to build a broad-based scientific foundation based on understanding the effects of stigma on the lives of persons with mental illness, the resources devoted to the organizations and families who care for them, and policies and programs designed to combat stigma. We end by discussing the clear implications this framework holds for stigma reduction, even in the face of conflicting results. PMID:18436358

Perspectives on perceived stigma and self-stigma in adult male patients with depression

PubMed Central

Latalova, Klara; Kamaradova, Dana; Prasko, Jan

2014-01-01

There are two principal types of stigma in mental illness, ie, “public stigma” and “self-stigma”. Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is “self-stigma”. Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms (“boys don’t cry”) leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men’s feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional. PMID:25114531

Measuring stigma among abortion providers: assessing the Abortion Provider Stigma Survey instrument.

PubMed

Martin, Lisa A; Debbink, Michelle; Hassinger, Jane; Youatt, Emily; Eagen-Torkko, Meghan; Harris, Lisa H

2014-01-01

We explored the psychometric properties of 15 survey questions that assessed abortion providers' perceptions of stigma and its impact on providers' professional and personal lives referred to as the Abortion Provider Stigma Survey (APSS). We administered the survey to a sample of abortion providers recruited for the Providers' Share Workshop (N = 55). We then completed analyses using Stata SE/12.0. Exploratory factor analysis, which resulted in 13 retained items and identified three subscales: disclosure management, resistance and resilience, and discrimination. Stigma was salient in abortion provider's lives: they identified difficulties surrounding disclosure (66%) and felt unappreciated by society (89%). Simultaneously, workers felt they made a positive contribution to society (92%) and took pride in their work (98%). Paired t-test analyses of the pre- and post-Workshop APSS scores showed no changes in the total score. However, the Disclosure Management subscale scores were significantly lower (indicating decreased stigma) for two subgroups of participants: those over the age of 30 and those with children. This analysis is a promising first step in the development of a quantitative tool for capturing abortion providers' experiences of and responses to pervasive abortion stigma.

Self-stigma in schizophrenia: a concept analysis.

PubMed

Omori, Yoshimi; Mori, Chizuru; White, Ann H

2014-01-01

This study aimed to clarify the phenomenon and definition of self-stigma in schizophrenia. Self-stigma in schizophrenia affects patients' well-being and attitudes to treatment. Although stigma and self-stigma have interactive and different characteristics, theses definitions are not clearly distinguished. Mental illnesses may have different stereotypes but are treated equally in some studies. Lack of awareness of illness is a common feature in schizophrenia but has not been focused in self-stigma studies. Further studies are needed to clarify the phenomenon of self-stigma in people with schizophrenia and to develop interventions targeted at reducing self-stigma. © 2014 Wiley Periodicals, Inc.

Stigma, status, and population health.

PubMed

Phelan, Jo C; Lucas, Jeffrey W; Ridgeway, Cecilia L; Taylor, Catherine J

2014-02-01

Stigma and status are the major concepts in two important sociological traditions that describe related processes but that have developed in isolation. Although both approaches have great promise for understanding and improving population health, this promise has not been realized. In this paper, we consider the applicability of status characteristics theory (SCT) to the problem of stigma with the goal of better understanding social systemic aspects of stigma and their health consequences. To this end, we identify common and divergent features of status and stigma processes. In both, labels that are differentially valued produce unequal outcomes in resources via culturally shared expectations associated with the labels; macro-level inequalities are enacted in micro-level interactions, which in turn reinforce macro-level inequalities; and status is a key variable. Status and stigma processes also differ: Higher- and lower-status states (e.g., male and female) are both considered normal, whereas stigmatized characteristics (e.g., mental illness) are not; interactions between status groups are guided by "social ordering schemas" that provide mutually agreed-upon hierarchies and interaction patterns (e.g., men assert themselves while women defer), whereas interactions between "normals" and stigmatized individuals are not so guided and consequently involve uncertainty and strain; and social rejection is key to stigma but not status processes. Our juxtaposition of status and stigma processes reveals close parallels between stigmatization and status processes that contribute to systematic stratification by major social groupings, such as race, gender, and SES. These parallels make salient that stigma is not only an interpersonal or intrapersonal process but also a macro-level process and raise the possibility of considering stigma as a dimension of social stratification. As such, stigma's impact on health should be scrutinized with the same intensity as that of other more

Understanding and influencing the stigma of mental illness.

PubMed

Corrigan, Patrick W; Wassel, Abigail

2008-01-01

Life goals and the opportunities that define them are impaired by the stigma of mental illness. Three kinds of stigma may act as barriers to personal aspirations: public stigma, self-stigma, and label avoidance. Challenging mental illness stigm is essential in helping individuals accomplish recovery-related goals. Public stigma may be changed through protest, education, and contact. Self-stigma can be addressed by fostering group identity, changing the perceived legitimacy of stigma through cognitive rehabilitation, and making strategic decisions about disclosing one's mental health history. Stigma change for label avoidance is not as well understood but may include the education and contact approaches used for public stigma. Evidence-based approaches to stigma change need to be substantiated by rigorous investigations.

Family Stigma and Caregiver Burden in Alzheimer's Disease

ERIC Educational Resources Information Center

Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

2012-01-01

Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

HIV-Related Stigma and Overlapping Stigmas Towards People Living With HIV Among Health Care Trainees in Canada.

PubMed

Wagner, Anne C; Girard, Todd; McShane, Kelly E; Margolese, Shari; Hart, Trevor A

2017-08-01

HIV continues to be a stigmatized disease, despite significant advances in care and concerted effort to reduce discrimination, stereotypes, and prejudice. Living with HIV is often associated with a multitude of overlapping and intersecting experiences which can, in and of themselves, also be stigmatized, and which may exacerbate HIV-related stigma. The consequences of these stigmatizing experiences are particularly impactful when the stigmatizing individual is a health care provider, as this can influence access to and quality of care. The current study empirically investigates a model of overlapping stigmas (homophobia, racism, sexism, stigma against injection drug use and stigma against sex work) potentially held by health care provider trainees in Canada to determine how these constructs overlap and intersect, and to assess whether HIV-related stigma may have unique attributes. Understanding overlapping stigmas can help inform targeted, stigma-informed training for health care trainees in order to provide effective, compassionate care for people living with HIV.

Stigma and mood disorders.

PubMed

Kelly, Claire M; Jorm, Anthony F

2007-01-01

To update the reader on current research on stigmatizing attitudes towards people suffering from mood disorders and to describe recent interventions in this area. The public generally feels their own attitudes are more favourable to people with depression than 'most other people's' attitudes are. Among those with depressive symptoms, self-stigma in relation to depression is higher than perceived stigma from others, including professionals, thus hindering help seeking. The main factor that seems to improve the attitudes towards people with any mental illness is personal contact. Moderate improvements in attitudes have been achieved with an online intervention. Caution must be taken when ensuring that improvements in knowledge about mental disorders do not lead to increased social distance. There exists little research on stigmatizing attitudes towards people with mood disorders. Most of the literature on the stigma towards people with mental illness relates to people with more severe disorders such as schizophrenia. When research has been done on mood disorders, the focus has been on perceived stigma and self-stigma. No up-to-date research exists on discrimination experienced by people with mood disorders, and very little research exists on interventions designed to decrease stigmatizing attitudes towards them.

Self-stigma and suicidality: a longitudinal study.

PubMed

Oexle, Nathalie; Rüsch, Nicolas; Viering, Sandra; Wyss, Christine; Seifritz, Erich; Xu, Ziyan; Kawohl, Wolfram

2017-06-01

Mental illness stigma is a source of distress for persons with mental illness. Self-stigma occurs when negative stereotypes are internalized, leading to low self-esteem, shame and hopelessness. Due to its consequences self-stigma may contribute to suicidality and be a modifiable target for suicide prevention. Based on 222 disability pensioners with mental illness we examined whether self-stigma at baseline is associated with suicidal ideation over a 2-year period, controlling for baseline suicidal ideation, symptoms, age and gender. More self-stigma predicted suicidal ideation at baseline and longitudinally. Interventions on different levels to reduce self-stigma could improve suicide prevention.

Developing a research agenda for reducing the stigma of addictions, part II: Lessons from the mental health stigma literature.

PubMed

Corrigan, Patrick W; Schomerus, Georg; Shuman, Valery; Kraus, Dana; Perlick, Debbie; Harnish, Autumn; Kulesza, Magdalena; Kane-Willis, Kathleen; Qin, Sang; Smelson, David

2017-01-01

Although advocates and providers identify stigma as a major factor in confounding the recovery of people with SUDs, research on addiction stigma is lacking, especially when compared to the substantive literature examining the stigma of mental illness. A comprehensive review of the stigma literature that yielded empirically supported concepts and methods from the mental health arena was contrasted with the much smaller and mostly descriptive findings from the addiction field. In Part I of this two part paper (American Journal of Addictions, Vol 26, pages 59-66, this issue), constructs and methods from the mental health stigma literature were used to summarize research that seeks to understand the phenomena of addiction stigma. In Paper II, we use this summary, as well as the extensive literature on mental illness stigma change, to outline a research program to develop and evaluate strategies meant to diminish impact on public and self-stigma (eg, education and contact). The paper ends with recommendations for next steps in addiction stigma research. (Am J Addict 2017;26:67-74). © 2016 American Academy of Addiction Psychiatry.

Perceived stigma in Korean adolescents with epilepsy: Effects of knowledge about epilepsy and maternal perception of stigma.

PubMed

Ryu, Han Uk; Lee, Sang-Ahm; Eom, Soyong; Kim, Heung-Dong

2015-01-01

There has been little research on whether the knowledge that adolescents with epilepsy (AWE) or their family have about the condition reduces their perception of stigma. In this study we determine the relation between AWE's perceived stigma of, and knowledge about, epilepsy and maternal perception of stigma. This was a cross-sectional multicenter study involving AWE and their mothers from 25 secondary or tertiary hospitals in Korea. The level of knowledge about epilepsy was assessed using 34 medical items of the Epilepsy Knowledge Profile-General (EKP-M). Additional questionnaires included the Child Stigma Scale, Parent Stigma Scale, and the Maternal Disclosure Management Scale. A total of 243 AWE and their mothers were included. The mean EKP-M score was 20.7 (range, 12-31) for AWE and 22.0 (range, 11-31) for their mothers. AWE and mothers had a neutral perception of stigma on average, but the maternal concealment behavior was high. Multiple linear regression indicated that AWE's knowledge about epilepsy was significantly related to their perception of stigma. Unexpectedly, AWE with a low level of knowledge reported a higher perception of stigma than those with a very low level of knowledge (β=0.280, p=0.040). In addition, higher maternal concealment behavior (β=0.070, p=0.002) and receiving polytherapy (β=0.240, p=0.046) were independent factors predicting higher perception of stigma in AWE. The knowledge that the AWE had about their epilepsy, maternal concealment behavior, and receiving polytherapy were significantly related to the AWE's perception of stigma. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

The Reciprocal Relationship between Suicidality and Stigma.

PubMed

Carpiniello, Bernardo; Pinna, Federica

2017-01-01

Although suicidality is frequently the cause of stigma, it is conversely true that stigma may be the cause of suicidality. The present paper focuses on the complex relationships that exist between suicidal behavior and stigmatizing attitudes. A narrative review of the topic will be presented on the basis of the relevant literature collected from an electronic search of PubMed, ISI Web of Knowledge, and Scopus databases, using stigma, public stigma, structural stigma, perceived stigma, self-stigma, suicide, attempted suicide, and suicidality as key words. A negative perception is frequently held of suicidal people, labeling them as weak and unable to cope with their problems, or selfish. Individuals who have attempted suicide are subject to similar processes of stigmatization and "social distancing"; insurance policies include an exclusion clause against death by suicide. Subjects with a direct personal experience of depression or suicide strongly endorse a feeling of self-stigma; those who have attempted suicide are often ashamed and embarrassed by their behavior and tend to hide the occurrence as much as possible. Similar processes are observed among family members of subjects who have committed suicide or made a suicide attempt, with a higher perceived stigma present in those bereaved by suicide. Perceived or internalized stigma produced by mental or physical disorders, or through belonging to a minority group, may represent a significant risk factor for suicide, being severely distressing, reducing self-esteem and acting as a barrier in help-seeking behaviors. With the aim of preventing suicide, greater efforts should be made to combat the persisting stigmatizing attitudes displayed toward mental disorders and suicide itself. Indeed, the role of stigma as a risk factor for suicide should further motivate and spur more concerted efforts to combat public stigma and support those suffering from perceived or internalized stigma. Experts and scientific societies

Stigma, status, and population health

PubMed Central

Phelan, Jo C.; Lucas, Jeffrey W.; Ridgeway, Cecilia L.; Taylor, Catherine J.

2014-01-01

Stigma and status are the major concepts in two important sociological traditions that describe related processes but that have developed in isolation. Although both approaches have great promise for understanding and improving population health, this promise has not been realized. In this paper, we consider the applicability of status characteristics theory (SCT) to the problem of stigma with the goal of better understanding social systemic aspects of stigma and their health consequences. To this end, we identify common and divergent features of status and stigma processes. In both, labels that are differentially valued produce unequal outcomes in resources via culturally shared expectations associated with the labels; macro-level inequalities are enacted in micro-level interactions, which in turn reinforce macro-level inequalities; and status is a key variable. Status and stigma processes also differ: Higher- and lower-status states (e.g., male and female) are both considered normal, whereas stigmatized characteristics (e.g., mental illness) are not; interactions between status groups are guided by “social ordering schemas” that provide mutually agreed-upon hierarchies and interaction patterns (e.g., men assert themselves while women defer), whereas interactions between “normals” and stigmatized individuals are not so guided and consequently involve uncertainty and strain; and social rejection is key to stigma but not status processes. Our juxtaposition of status and stigma processes reveals close parallels between stigmatization and status processes that contribute to systematic stratification by major social groupings, such as race, gender, and SES. These parallels make salient that stigma is not only an interpersonal or intrapersonal process but also a macro-level process and raise the possibility of considering stigma as a dimension of social stratification. As such, stigma’s impact on health should be scrutinized with the same intensity as that of

Stigma in mothers of deaf children.

PubMed

Ebrahimi, Hossein; Mohammadi, Eissa; Mohammadi, Mohammad Ali; Pirzadeh, Akbar; Mahmoudi, Hamzeh; Ansari, Ismail

2015-03-01

A deaf child creates a feeling of stigma in many hearing parents. Stigma in mothers can have a negative impact on a child's treatment and rehabilitation process. Therefore, this study was conducted to evaluate the extent of stigma in mothers with deaf children. This descriptive, cross-sectional study was conducted in 2013 among 90 mothers with deaf children. The data-collection instrument included the stigma scale in the mothers of children with disabilities. The reliability and validity of the instrument were confirmed through content validity and Cronbach's alpha coefficient (α=86%), respectively. Data were analyzed using SPSS-15 software. Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child's deafness. There was an inverse relationship between the mother's level of education and mean stigma scores (P<0.033). The stigma score was higher in mothers who were living independently of their relatives (P<0.029). The mean stigma score in mothers of children with a cochlear implant was lower than that of mothers of children with earphones (86.70 vs. 99.64), and this difference tended towards significance (P=0.057). This study showed that half of all mothers with deaf children were scorned and felt ashamed of having a deaf child in the family because of the stigma. The majority of mothers with deaf children felt stigmatized, and only their education and residency status affected this issue. The mothers of cochlear-implanted children perceived less stigma. Due to the various social and psychological problems caused by hearing impairment, it is necessary to consider the emotional health and psychological state of the mothers in addition to rehabilitation programs and standard services for the children themselves.

Stigma in Mothers of Deaf Children

PubMed Central

Ebrahimi, Hossein; Mohammadi, Eissa; Mohammadi, Mohammad Ali; Pirzadeh, Akbar; Mahmoudi, Hamzeh; Ansari, Ismail

2015-01-01

Introduction: A deaf child creates a feeling of stigma in many hearing parents. Stigma in mothers can have a negative impact on a child’s treatment and rehabilitation process. Therefore, this study was conducted to evaluate the extent of stigma in mothers with deaf children. Materials and Methods: This descriptive, cross-sectional study was conducted in 2013 among 90 mothers with deaf children. The data-collection instrument included the stigma scale in the mothers of children with disabilities. The reliability and validity of the instrument were confirmed through content validity and Cronbach’s alpha coefficient (α=86%), respectively. Data were analyzed using SPSS-15 software. Results: Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child’s deafness. There was an inverse relationship between the mother’s level of education and mean stigma scores (P<0.033). The stigma score was higher in mothers who were living independently of their relatives (P<0.029). The mean stigma score in mothers of children with a cochlear implant was lower than that of mothers of children with earphones (86.70 vs. 99.64), and this difference tended towards significance (P=0.057). Conclusion: This study showed that half of all mothers with deaf children were scorned and felt ashamed of having a deaf child in the family because of the stigma. The majority of mothers with deaf children felt stigmatized, and only their education and residency status affected this issue. The mothers of cochlear-implanted children perceived less stigma. Due to the various social and psychological problems caused by hearing impairment, it is necessary to consider the emotional health and psychological state of the mothers in addition to rehabilitation

The value of reducing HIV stigma.

PubMed

Brent, Robert J

2016-02-01

HIV-stigma is a major reason why HIV continues to be a global epidemic. Interventions targeting HIV-stigma are therefore necessary. To find an intervention that is worthwhile, a Cost-Benefit Analysis is needed which compares costs and benefits. There are many documented costs of HIV-stigma. What is missing is a valuation of the benefits of reducing HIV-stigma. The purpose of this paper is to present a general method that can be used to value the benefits of stigma reduction programs. The method involves estimating the marginal rate of substitution (MRS) between stigma and income in the utility function of older people with HIV. To illustrate how our framework can be used, we applied it to a sample of just over 900 people coming from the 2005-06 ROAH study (Research on Older Adults with HIV) in New York City. Copyright © 2016 Elsevier Ltd. All rights reserved.

[The stigma of mental illness: concepts, forms, and consequences].

PubMed

Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W

2005-07-01

Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. We aim to clarify the concept of mental illness stigma and discuss important consequences for people with mental illness. A search of scientific literature on mental illness stigma was conducted with a focus on conceptually relevant empirical studies. After giving a conceptual overview of stigma, we elaborate on the consequences of stigma, focussing on self-stigma/empowerment, coping behaviour, fear of stigma as a barrier to using health services, and on structural discrimination. Main strategies to reduce stigma -- protest, education, and contact -- are discussed. Stigma is of central importance to persons with mental illness, both to how they experience their illness and its consequences and whether they use available health services. Well-designed anti-stigma initiatives will help to diminish the impact of mental illness stigma.

AFLP and MS-AFLP Analysis of the Variation within Saffron Crocus (Crocus sativus L.) Germplasm

PubMed Central

Busconi, Matteo; Colli, Licia; Sánchez, Rosa Ana; Santaella, Marcela; De-Los-Mozos Pascual, Marcelino; Santana, Omar; Roldán, Marta; Fernández, José-Antonio

2015-01-01

The presence and extent of genetic variation in saffron crocus are still debated, as testified by several contradictory articles providing contrasting results about the monomorphism or less of the species. Remarkably, phenotypic variations have been frequently observed in the field, such variations are usually unstable and can change from one growing season to another. Considering that gene expression can be influenced both by genetic and epigenetic changes, epigenetics could be a plausible cause of the alternative phenotypes. In order to obtain new insights into this issue, we carried out a molecular marker analysis of 112 accessions from the World Saffron and Crocus Collection. The accessions were grown for at least three years in the same open field conditions. The same samples were analysed using Amplified Fragment Length Polymorphism (AFLP) and Methyl Sensitive AFLP in order to search for variation at the genetic (DNA sequence) and epigenetic (cytosine methylation) level. While the genetic variability was low (4.23% polymorphic peaks and twelve (12) effective different genotypes), the methyl sensitive analysis showed the presence of high epigenetic variability (33.57% polymorphic peaks and twenty eight (28) different effective epigenotypes). The pattern obtained by Factorial Correspondence Analysis of AFLP and, in particular, of MS-AFLP data was consistent with the geographical provenance of the accessions. Very interestingly, by focusing on Spanish accessions, it was observed that the distribution of the accessions in the Factorial Correspondence Analysis is not random but tends to reflect the geographical origin. Two clearly defined clusters grouping accessions from the West (Toledo and Ciudad Real) and accessions from the East (Cuenca and Teruel) were clearly recognised. PMID:25885113

HIV-positive mothers and stigma.

PubMed

Ingram, D; Hutchinson, S A

1999-01-01

Our purpose in this paper is to demonstrate how stigma pervades the lives of human immunodeficiency virus (HIV)-positive mothers and their children. Data from a grounded theory study on HIV-positive mothers are used to illustrate Goffman's theory of stigma. This research is an example of "emergent fit," where extant theory is discovered by the interpretive researchers to fit much of the data. The sample included 18 HIV-positive mothers who participated in in-depth interviews. The HIV-positive mothers valued being perceived as normal but acknowledged that normalcy was lost for them because of the stigma of HIV. Consequently, they tried to pass as normal by managing information and manipulating their environment. They attempted to cover up their illness by lying and pretending. Health care professionals can provide quality, client-centered care when they understand the power that stigma holds over these women and the strategies that effectively mitigate the stigma.

Stigma scale of epilepsy: the perception of epilepsy stigma in different cities in Brazil.

PubMed

Fernandes, Paula T; Noronha, Ana Lúcia A; Sander, Josemir W; Li, Li M

2008-09-01

To assess the perception of epilepsy stigma in different regions of Brazil. The Stigma Scale of Epilepsy (SSE) questionnaire was applied to people in different Brazilian urban settings. The survey was performed on individual basis; an interviewer read the questions to the subjects and wrote down the answers. The same procedure was applied to all the subjects and took around 10 minutes. 266 questionnaires were completed in four different towns of Brazil (Curitiba=83; São Paulo=47; Vila Velha=79; Ipatinga=57). The overall stigma score was 49.7 (median). Different scores were obtained in each locality. Vila Velha=42; Curitiba=49; São Paulo=52; Ipatinga=54 (ANOVA [2.262]=3.82; p=0.01). This study showed differences in the perception of stigma, which may depend on cultural and regional aspects. The concept of stigma has cultural perspectives, depending on the region and the context where each person lives. The understanding of this aspect of epilepsy is important to promote better de-stigmatization campaigns, considering the cultural and social differences.

Evidence for the indirect effects of perceived public stigma on psychosocial outcomes: The mediating role of self-stigma.

PubMed

Kao, Yu-Chen; Lien, Yin-Ju; Chang, Hsin-An; Wang, Sheng-Chiang; Tzeng, Nian-Sheng; Loh, Ching-Hui

2016-06-30

This study examined the possible mediating role of self-stigma in the relationship between perceived public stigma and psychosocial outcomes and how this mechanism may be contingent on illness severity in a non-Western (Chinese) sample. A total of 251 participants, namely 151 psychiatric outpatients with psychotic disorders and 100 psychiatric outpatients without psychotic disorders, completed a questionnaire on stigma and psychosocial outcomes that covered topics such as self-esteem, depressive symptoms, and subjective quality of life (QoL). Using a cross-sectional design, ordinary least squares regression and bootstrapping mediation analyses were used to test whether self-stigma mediated the relationship between perceived public stigma and psychosocial outcomes and whether this mediating process was moderated by diagnostic status. The results indicated that self-stigma mediated the effect of perceived public stigma on psychosocial outcomes such as self-esteem, depressive symptoms, and subjective QoL among both patients with psychotic disorders and those without psychotic disorders after controlling for demographic and clinical characteristics. Further, moderated mediation analyses revealed that the indirect effect of perceived public stigma on psychosocial outcomes were not moderated by the status of psychotic diagnoses. Self-stigma might be an essential and tractable target for interventions aimed at breaking the vicious cycle of discrimination and stigmatization toward people with mental illness regardless of their diagnoses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Deaf Stigma: Links Between Stigma and Well-Being Among Deaf Emerging Adults.

PubMed

Mousley, Victoria L; Chaudoir, Stephenie R

2018-05-31

Although stigma has been linked to suboptimal psychological and physical health outcomes in marginalized communities such as persons of color, sexual minorities, and people living with HIV/AIDS, no known research has examined these effects among deaf individuals. In the present research, we examine the associations between anticipated, enacted, and internalized stigma and psychological well-being (i.e., depressive symptoms, anxiety) and physical well-being (i.e., quality of life, alcohol use) among a sample of 171 deaf emerging adults. Furthermore, we consider whether trait resilience and benefit-finding moderate these effects. Enacted stigma, but not anticipated or internalized stigma, was related to worse depressive symptoms, anxiety, and quality of life. However, none of these variables predicted alcohol use and neither resilience nor benefit-finding moderated these effects. These findings are consistent with other research among marginalized populations, though they are also the first to suggest that experiences of discrimination are related to suboptimal well-being among deaf emerging adults. The discussion considers how these findings may illuminate the potential causes of disparities in well-being between hearing and deaf emerging adults.

Understanding the importance of "symbolic interaction stigma": How expectations about the reactions of others adds to the burden of mental illness stigma.

PubMed

Link, Bruce G; Wells, Jennifer; Phelan, Jo C; Yang, Lawrence

2015-06-01

Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called symbolic interaction stigma and can have an impact even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced, and a preliminary assessment of their impact is provided. Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness, and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N = 65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem, and isolation from relatives independent of measures of internalization of stigma and rejection experiences. As evidenced by scores on 4 distinct measures, symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. In addition, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem, and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed. (c) 2015 APA, all rights reserved).

The Burden of Stigma on Health and Well-Being: A Taxonomy of Concealment, Course, Disruptiveness, Aesthetics, Origin, and Peril Across 93 Stigmas.

PubMed

Pachankis, John E; Hatzenbuehler, Mark L; Wang, Katie; Burton, Charles L; Crawford, Forrest W; Phelan, Jo C; Link, Bruce G

2018-04-01

Most individuals are stigmatized at some point. However, research often examines stigmas separately, thus underestimating the overall impact of stigma and precluding comparisons across stigmatized identities and conditions. In their classic text, Social Stigma: The Psychology of Marked Relationships, Edward Jones and colleagues laid the groundwork for unifying the study of different stigmas by considering the shared dimensional features of stigmas: aesthetics, concealability, course, disruptiveness, origin, peril. Despite the prominence of this framework, no study has documented the extent to which stigmas differ along these dimensions, and the implications of this variation for health and well-being. We reinvigorated this framework to spur a comprehensive account of stigma's impact by classifying 93 stigmas along these dimensions. With the input of expert and general public raters, we then located these stigmas in a six-dimensional space and created discrete clusters organized around these dimensions. Next, we linked this taxonomy to health and stigma-related mechanisms. This quantitative taxonomy offers parsimonious insights into the relationship among the numerous qualities of numerous stigmas and health.

A Positive Stigma for Child Labor?

ERIC Educational Resources Information Center

Patrinos, Harry Anthony; Shafiq, M. Najeeb

2008-01-01

We introduce a simple empirical model that assumes a positive stigma (or norm) towards child labor that is common in some developing countries. We then illustrate our positive stigma model using data from Guatemala. Controlling for several child- and household-level characteristics, we use two instruments for measuring stigma: a child's indigenous…

Stigma Sensitivity and the Duration of Temporary Closure Are Affected by Pollinator Identity in Mazus miquelii (Phrymaceae), a Species with Bilobed Stigma

PubMed Central

Jin, Xiao-Fang; Ye, Zhong-Ming; Amboka, Grace M.; Wang, Qing-Feng; Yang, Chun-Feng

2017-01-01

A sensitive bilobed stigma is thought to assure reproduction, avoid selfing and promote outcrossing. In addition, it may also play a role in pollinator selection since only pollinators with the appropriate body size can trigger this mechanism. However, no experimental study has investigated how the sensitive stigma responds to different pollinators and its potential effects on pollination. Mazus miquelii (Phrymaceae), a plant with a bilobed stigma was studied to investigate the relationship between stigma behaviors and its multiple insect pollinators. The reaction time of stigma closure after touched, duration of temporary closure, and factors determining permanent closure of the stigma were studied when flowers were exposed to different visitors and conducted with hand pollination. Manual stimulation was also used to detect the potential differences in stigmas when touched with different degrees of external forces. Results indicated that, compared to pollinators with a small body size, larger pollinators transferred more pollen grains to the stigma, causing a rapid stigma response and resulting in a higher percentage of permanent closures. Duration of temporary closure was negatively correlated with the speed of stigma closure; a stigma that closed more rapidly reopened more slowly. Manual stimulation showed that reaction time of stigma closure was likely a response to external mechanical forces. Hand pollination treatments revealed that the permanent closure of a stigma was determined by the size of stigmatic pollen load. For large pollinators, the speedy reaction of the stigma might help to reduce pollen loss, enhance pollen germination and avoid obstructing pollen export. Stigmas showed low sensitivity when touched by inferior pollinators, which may have increased the possibility of pollen deposition by subsequent visits. Therefore, the stigma behavior in M. miquelii is likely a mechanism of pollinator selection to maximize pollination success. PMID:28539934

Stigma Sensitivity and the Duration of Temporary Closure Are Affected by Pollinator Identity in Mazus miquelii (Phrymaceae), a Species with Bilobed Stigma.

PubMed

Jin, Xiao-Fang; Ye, Zhong-Ming; Amboka, Grace M; Wang, Qing-Feng; Yang, Chun-Feng

2017-01-01

A sensitive bilobed stigma is thought to assure reproduction, avoid selfing and promote outcrossing. In addition, it may also play a role in pollinator selection since only pollinators with the appropriate body size can trigger this mechanism. However, no experimental study has investigated how the sensitive stigma responds to different pollinators and its potential effects on pollination. Mazus miquelii (Phrymaceae), a plant with a bilobed stigma was studied to investigate the relationship between stigma behaviors and its multiple insect pollinators. The reaction time of stigma closure after touched, duration of temporary closure, and factors determining permanent closure of the stigma were studied when flowers were exposed to different visitors and conducted with hand pollination. Manual stimulation was also used to detect the potential differences in stigmas when touched with different degrees of external forces. Results indicated that, compared to pollinators with a small body size, larger pollinators transferred more pollen grains to the stigma, causing a rapid stigma response and resulting in a higher percentage of permanent closures. Duration of temporary closure was negatively correlated with the speed of stigma closure; a stigma that closed more rapidly reopened more slowly. Manual stimulation showed that reaction time of stigma closure was likely a response to external mechanical forces. Hand pollination treatments revealed that the permanent closure of a stigma was determined by the size of stigmatic pollen load. For large pollinators, the speedy reaction of the stigma might help to reduce pollen loss, enhance pollen germination and avoid obstructing pollen export. Stigmas showed low sensitivity when touched by inferior pollinators, which may have increased the possibility of pollen deposition by subsequent visits. Therefore, the stigma behavior in M. miquelii is likely a mechanism of pollinator selection to maximize pollination success.

Comparison of long-term results of computer-assisted anti-stigma education and reading anti-stigma educational materials.

PubMed

Finkelstein, Joseph; Lapshin, Oleg; Wasserman, Evgeny

2007-10-11

Professionals working with psychiatric patients very often have negative beliefs and attitudes about their clients. We designed our study to investigate the effectiveness of anti-stigma interventions among university students who are trained to provide special education. The objective of our study was to compare sustainability of the effect of two anti-stigma education programs. We enrolled 91 college students from the School of Special Education at the Herzen Russian State Pedagogic University (St Petersburg, Russia). Of those, 36 read two articles and World Health Organization brochure (reading group, RG) devoted to the problem of psychiatric stigma, and 32 studied an anti-stigma web-based program (program group, PG). Twenty-three students were in a control group (CG) and received no intervention. The second study visit in six months was completed by 65 students. To measure the level of stigma we used the Community Attitudes toward the Mentally Ill (CAMI) questionnaire. The web-based program was based on the Computer-assisted Education system (CO-ED) which we described previously. The CO-ED system provides self-paced interactive education driven by adult learning theories. At the time of their first visit the age of the study participants was 19.0+/-1.2 years; of them, 99% were females. After the intervention in PG, the level of stigma assessed by CAMI decreased from 24.0+/-5.0 to 15.8+/- 4.6 points (p<0.0001). In RG the level of stigma dropped from 24.1+/-6.1 to 20.3+/-6.4 points (p<0.0001). In six months after the intervention the analysis of CAMI scores showed that the level of stigma in PG was significantly lower than in CG and RG (20.2+/-6.2 in CG, 21.3+/-6.5 in RG, and 18.7+/-4.9 in PG, p<0.01). Web-based education or reading anti-stigma materials could be effective in reducing psychiatric stigma among university students. The effect of interactive web-based education based on adult learning theories was more stable as assessed in six months.

Developing a research agenda for understanding the stigma of addictions Part I: Lessons from the Mental Health Stigma Literature.

PubMed

Corrigan, Patrick; Schomerus, Georg; Shuman, Valery; Kraus, Dana; Perlick, Debbie; Harnish, Autumn; Kulesza, Magdalena; Kane-Willis, Kathleen; Qin, Sang; Smelson, David

2017-01-01

Although advocates and providers identify stigma as a major factor in confounding the recovery of people with SUDs, research on addiction stigma is lacking, especially when compared to the substantive literature examining the stigma of mental illness. A review of key studies from the stigma literature that yielded empirically supported concepts and methods from the mental health arena was contrasted with the much smaller and mostly descriptive findings from the addiction field. Integration of this information led to Part I of this two part paper, development of a research paradigm seeking to understand phenomena of addiction stigma (eg, stereotypes, prejudice, and discrimination) and its different types (public, self, and label avoidance). In Part II paper (American Journal of Addictions, Vol 26, pages 67-74, this issue), we address how this literature informs a research program meant to develop and evaluate and stigma strategies (eg, education, contact, and protest). Both papers end with recommendations for next steps to jumpstart the addiction stigma portfolio. Here in Part I, we offer one possible list of key research issues for studies attempting to describe or explain addiction stigma. (Am J Addict 2017;26:59-66). © 2016 American Academy of Addiction Psychiatry.

The stigma of childhood mental disorders: a conceptual framework.

PubMed

Mukolo, Abraham; Heflinger, Craig Anne; Wallston, Kenneth A

2010-02-01

To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus on theory and measurement. A total of 145 articles in PsychInfo and 77 articles in MEDLINE met search criteria. The review process involved identifying and appraising literature convergence on the definition of critical dimensions of stigma, antecedents, and outcomes reported in empirical studies. We found concurrence on three dimensions of stigma (negative stereotypes, devaluation, and discrimination), two contexts of stigma (self, general public), and two targets of stigma (self/individual, family). Theory and empirics on institutional and self-stigma in child populations were sparse. Literature reports few theoretic frameworks and conceptualizations of child mental illness stigma. One model of help seeking (the FINIS) explicitly acknowledges the role of stigma in children's access and use of mental health services. Compared with adults, children are subject to unique stigmatizing contexts that have not been adequately studied. The field needs conceptual frameworks that get closer to stigma experiences that are causally linked to how parents/caregivers cope with children's emotional and behavioral problems, such as seeking professional help. To further research in child mental illness, we suggest an approach to adapting current theoretical frameworks and operationalizing stigma, highlighting three dimensions of stigma, three contexts of stigma (including institutions), and three targets of stigma (self/child, family, and services).

INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

PubMed

Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

2016-03-01

Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia.

Sexual Behavior as a Function of Stigma and Coping with Stigma Among People with HIV/AIDS in Rural New England

PubMed Central

Solomon, Sondra E.

2012-01-01

The relationship between coping with HIV/AIDS stigma and engaging in risky sexual behavior (i.e., inconsistent condom use) was examined in HIV-positive adults living in rural areas. Participants answered questions about their experiences with HIV/AIDS prejudice and discrimination (enacted stigma) and their perceptions of felt HIV/AIDS stigma (disclosure concerns, negative self-image, and concern with public attitudes). They were also asked about how they coped with HIV/AIDS stigma, and about their sexual activity during the past 90 days. We hypothesized that using disengagement coping to manage the stress of HIV/AIDS stigma would be related to risky sexual behavior. Multinomial logistic regression results showed that using disengagement coping (avoidance, denial, and wishful thinking) coupled with high levels of enacted stigma was associated with less risky rather than more risky sexual behavior. That is, disengagement coping coupled with high stigma increased the odds of not having vaginal or anal sex versus inconsistently using condoms. Implications for people with HIV/AIDS who use disengagement coping to manage stress to deal with HIV/AIDS stigma are discussed. PMID:22782789

Sexual behavior as a function of stigma and coping with stigma among people with HIV/AIDS in rural New England.

PubMed

Varni, Susan E; Miller, Carol T; Solomon, Sondra E

2012-11-01

The relationship between coping with HIV/AIDS stigma and engaging in risky sexual behavior (i.e., inconsistent condom use) was examined in HIV-positive adults living in rural areas. Participants answered questions about their experiences with HIV/AIDS prejudice and discrimination (enacted stigma) and their perceptions of felt HIV/AIDS stigma (disclosure concerns, negative self-image, and concern with public attitudes). They were also asked about how they coped with HIV/AIDS stigma, and about their sexual activity during the past 90 days. We hypothesized that using disengagement coping to manage the stress of HIV/AIDS stigma would be related to risky sexual behavior. Multinomial logistic regression results showed that using disengagement coping (avoidance, denial, and wishful thinking) coupled with high levels of enacted stigma was associated with less risky rather than more risky sexual behavior. That is, disengagement coping coupled with high stigma increased the odds of not having vaginal or anal sex versus inconsistently using condoms. Implications for people with HIV/AIDS who use disengagement coping to manage stress to deal with HIV/AIDS stigma are discussed.

Determinants of felt stigma in epilepsy.

PubMed

Aydemir, N; Kaya, B; Yıldız, G; Öztura, I; Baklan, B

2016-05-01

The present study aimed to determine the level of felt stigma, overprotection, concealment, and concerns related to epilepsy in different life domains by using culturally-specific scales for Turkish individuals with epilepsy. Also, it aimed to detect relations among the study variables and to determine the variables which predict felt stigma. For this purpose, felt stigma scale, overprotection scale, concealment of epilepsy scale, and concerns of epilepsy scale were administered to two hundred adult persons with epilepsy (PWE). The results showed that almost half of the participants reported felt stigma, overprotection, concealment of epilepsy, concerns related to future occupation, and concerns related to social life. Almost all the study variables show correlations with each other. Concealment of epilepsy, concerns related to social life, and concerns related to future occupation were found as the predictors of felt stigma. Copyright © 2016 Elsevier Inc. All rights reserved.

Target-specific stigma change: a strategy for impacting mental illness stigma.

PubMed

Corrigan, Patrick W

2004-01-01

In the past decade, mental health advocates and researchers have sought to better understand stigma so that the harm it causes can be erased. In this paper, we propose a target-specific stigma change model to organize the diversity of information into a cogent framework. "Target" here has a double meaning: the power groups that have some authority over the life goals of people with mental illness and specific discriminatory behaviors which power groups might produce that interfere with these goals. Key power groups in the model include landlords, employers, health care providers, criminal justice professionals, policy makers, and the media. Examples are provided of stigmatizing attitudes that influence the discriminatory behavior and social context in which the power group interacts with people with mental illness. Stigma change is most effective when it includes all the components that describe how a specific power group impacts people with mental illness.

Disease and Stigma: A Review of Literature

ERIC Educational Resources Information Center

Pettit, Michele L.

2008-01-01

This article presents a review of literature pertaining to disease and stigma. Specifically, a definition of stigma is provided along with an historical overview of disease and stigma and research trends related to three public health perils-AIDS, mental illness, and obesity.

Mental illness stigma, secrecy and suicidal ideation.

PubMed

Oexle, N; Ajdacic-Gross, V; Kilian, R; Müller, M; Rodgers, S; Xu, Z; Rössler, W; Rüsch, N

2017-02-01

Whether the public stigma associated with mental illness negatively affects an individual, largely depends on whether the person has been labelled 'mentally ill'. For labelled individuals concealing mental illness is a common strategy to cope with mental illness stigma, despite secrecy's potential negative consequences. In addition, initial evidence points to a link between stigma and suicidality, but quantitative data from community samples are lacking. Based on previous literature about mental illness stigma and suicidality, as well as about the potential influence of labelling processes and secrecy, a theory-driven model linking perceived mental illness stigma and suicidal ideation by a mediation of secrecy and hopelessness was established. This model was tested separately among labelled and unlabelled persons using data derived from a Swiss cross-sectional population-based study. A large community sample of people with elevated psychiatric symptoms was examined by interviews and self-report, collecting information on perceived stigma, secrecy, hopelessness and suicidal ideation. Participants who had ever used mental health services were considered as labelled 'mentally ill'. A descriptive analysis, stratified logistic regression models and a path analysis testing a three-path mediation effect were conducted. While no significant differences between labelled and unlabelled participants were observed regarding perceived stigma and secrecy, labelled individuals reported significantly higher frequencies of suicidal ideation and feelings of hopelessness. More perceived stigma was associated with suicidal ideation among labelled, but not among unlabelled individuals. In the path analysis, this link was mediated by increased secrecy and hopelessness. Results from this study indicate that among persons labelled 'mentally ill', mental illness stigma is a contributor to suicidal ideation. One explanation for this association is the relation perceived stigma has with

Defining the research agenda to measure and reduce tuberculosis stigmas.

PubMed

Macintyre, K; Bakker, M I; Bergson, S; Bhavaraju, R; Bond, V; Chikovore, J; Colvin, C; Craig, G M; Cremers, A L; Daftary, A; Engel, N; France, N Ferris; Jaramillo, E; Kimerling, M; Kipp, A; Krishnaratne, S; Mergenthaler, C; Ngicho, M; Redwood, L; Rood, E J J; Sommerland, N; Stangl, A; van Rie, A; van Brakel, W; Wouters, E; Zwerling, A; Mitchell, E M H

2017-11-01

Crucial to finding and treating the 4 million tuberculosis (TB) patients currently missed by national TB programmes, TB stigma is receiving well-deserved and long-delayed attention at the global level. However, the ability to measure and evaluate the success of TB stigma-reduction efforts is limited by the need for additional tools. At a 2016 TB stigma-measurement meeting held in The Hague, The Netherlands, stigma experts discussed and proposed a research agenda around four themes: 1) drivers: what are the main drivers and domains of TB stigma(s)?; 2) consequences: how consequential are TB stigmas and how are negative impacts most felt?; 3) burden: what is the global prevalence and distribution of TB stigma(s) and what explains any variation? 4): intervention: what can be done to reduce the extent and impact of TB stigma(s)? Each theme was further subdivided into research topics to be addressed to move the agenda forward. These include greater clarity on what causes TB stigmas to emerge and thrive, the difficulty of measuring the complexity of stigma, and the improbability of a universal stigma 'cure'. Nevertheless, these challenges should not hinder investments in the measurement and reduction of TB stigma. We believe it is time to focus on how, and not whether, the global community should measure and reduce TB stigma.

Stigma and bipolar disorder: a review of the literature.

PubMed

Hawke, Lisa D; Parikh, Sagar V; Michalak, Erin E

2013-09-05

Psychiatric stigma is pervasive injustice that complicates the course of illness and reduces quality of life for people with mental illnesses. This article reviews the research examining stigma towards bipolar disorder (BD) with a view to guiding the development of stigma reduction initiatives and ongoing research. PsychInfo, Medline, and Embase databases were searched for peer-reviewed studies addressing stigma in BD. Stigma is a serious concern for individuals with BD and their families. Stigma occurs within affected individuals, families, social environments, work and school environments, and the healthcare industry. With stigma often come a loss of social support and occupational success, reduced functioning, higher symptom levels and lower quality of life. BD stigma is comparable to that of other severe mental illnesses, such as schizophrenia. Few interventions are available to specifically target stigma against BD. Most studies have used explicit, attitude-based measures of stigma without controlling for social desirability, which may not translate into real-world stigmatizing behaviors. Furthermore, many studies have not clearly delineated results in a manner consistent with the conceptual framework of stigmatization. Stigma toward BD is ubiquitous and has insidious consequences for affected individuals and their families. Stigma reduction initiatives should target individuals living with BD, their families, workplaces, and the healthcare industry, taking into account the experiences and impacts of BD stigma to improve social support, course of illness, and quality of life. Copyright © 2013 Elsevier B.V. All rights reserved.

Mediating effects of self-stigma on the relationship between perceived stigma and psychosocial outcomes among psychiatric outpatients: findings from a cross-sectional survey in Singapore

PubMed Central

Picco, Louisa; Lau, Ying Wen; Pang, Shirlene; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

2017-01-01

Objectives To examine whether self-stigma mediates the relationship between perceived stigma and quality of life, self-esteem and general functioning among outpatients with depression, schizophrenia, anxiety and obsessive-compulsive disorder (OCD). Design Cross-sectional survey. Setting Outpatient clinics at a tertiary psychiatric hospital in Singapore. Participants 280 outpatients with a primary clinical diagnosis of either schizophrenia, depression, anxiety or OCD. Methods Data were collected in relation to self-stigma, perceived stigma, self-esteem, functioning and quality of life. In order to examine the mediating role of self-stigma on the relationship between perceived stigma and psychosocial outcomes, bootstrapping mediation analyses were used. Results Mediation analyses revealed that the relationship between perceived stigma and psychosocial outcomes was subject to the effects of self-stigma among the overall sample. Separate mediation analyses were conducted by diagnoses and showed differences in the mediating effects of self-stigma. Among the whole sample and the subsample with OCD, self-stigma mediated the relationship between perceived stigma and all psychosocial outcomes. For those with anxiety, depression and schizophrenia, the mediating effects of self-stigma were present in all relationships except (1) perceived stigma with physical health in the anxiety sample, (2) perceived stigma with social relationships in the depression sample and (3) perceived stigma with physical health in the schizophrenia sample. Conclusions The mediating effects of self-stigma on the relationship between perceived stigma and various psychosocial outcomes are evident and differ across diagnoses. Interventions to address and reduce the effects of self-stigma along with targeted treatments and psychoeducation to assist people with mental illness overcome or better manage self-stigma while providing them the skills to counteract public stigma are needed. PMID:28851803

Development of parallel scales to measure HIV-related stigma

PubMed Central

Visser, Maretha J.; Kershaw, Trace; Makin, Jennifer D.; Forsyth, Brian W.C.

2014-01-01

HIV-related stigma is a multidimensional concept which has pervasive effects on the lives of HIV-infected people as well as serious consequences for the management of HIV/AIDS. In this research three parallel stigma scales were developed to assess personal views of stigma, stigma attributed to others, and internalized stigma experienced by HIV-infected individuals. The stigma scales were administered in two samples: a community sample of 1077 respondents and 317 HIV-infected pregnant women recruited at clinics from the same community in Tshwane (South Africa). A two-factor structure referring to moral judgment and interpersonal distancing was confirmed across scales and sample groups. The internal consistency of the scales was acceptable and evidence of validity is reported. Parallel scales to assess and compare different perspectives of stigma provide opportunities for research aimed at understanding of stigma, assessing the consequences or evaluating possible interventions aimed at reducing stigma. PMID:18266101

HIV stigma experiences and stigmatisation before and after a HIV stigma-reduction community "hub" intervention.

PubMed

Prinsloo, Catharina Dorothea; Greeff, Minrie; Kruger, Annamarie; Khumalo, Itumeleng Paul

2017-09-01

This study sought to explore, describe and determine whether an HIV stigma-reduction community "hub" intervention would change the HIV stigma experiences of people living with HIV (PLWH) and the stigmatisation by the community in an urban area in South Africa. A convergent parallel mixed-method design with a single case pre-test post-test design and an interpretive description approach was utilised. The sample for this study included 62 PLWH recruited through accessibility sampling and 570 community members recruited through random voluntary sampling. A sub-sample of both groups, selected using purposive voluntary sampling, was utilised for the in-depth interviews about stigma experiences of PLWH, and for perceptions and attitudes of the community toward PLWH. Both quantitative and qualitative data showed that stigma is present. Although no statistically significant changes were found, small practically significant changes were demonstrated in the experiences of PLWH and in the perceptions and attitudes of the community. The extent of changes was much more obvious in the responses of the PLWH and the community during their post-intervention qualitative interviews than the changes found with the quantitative measures. This study thus concludes that the HIV stigma-reduction community hub intervention was successful in initiating the onset of changes in a community through the PLWH and people living close to PLWH (PLC) as community mobilisers active in the community hub to mobilise their own communities towards HIV stigma reduction through social change.

Abortion providers, stigma and professional quality of life.

PubMed

Martin, Lisa A; Debbink, Michelle; Hassinger, Jane; Youatt, Emily; Harris, Lisa H

2014-12-01

The Providers Share Workshop (PSW) provides abortion providers safe space to discuss their work experiences. Our objectives were to assess changes in abortion stigma over time and explore how stigma is related to aspects of professional quality of life, including compassion satisfaction, burnout and compassion fatigue for providers participating in the workshops. Seventy-nine providers were recruited to the PSW study. Surveys were completed prior to, immediately following and 1 year after the workshops. The outcome measures were the Abortion Provider Stigma Survey and the Professional Quality of Life (ProQOL) survey. Baseline ProQOL scores were compared to published averages using t tests. Changes in abortion stigma and aspects of professional quality of life were assessed by fitting a two-level random-effects model with repeated measures at level 1 (period-level) and static measures (e.g., demographic data) at level 2 (person-level). Potential covariates included age, parenting status, education, organizational tenure, job type and clinic type (stand-alone vs. hospital-based clinics). Compared to other healthcare workers, abortion providers reported higher compassion satisfaction (t=2.65, p=.009) and lower burnout (t=5.13, p<.0001). Repeated-measures analysis revealed statistically significant decreases in stigma over time. Regression analysis identified abortion stigma as a significant predictor of lower compassion satisfaction, higher burnout and higher compassion fatigue. Participants in PSW reported a reduction in abortion stigma over time. Further, stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue, suggesting that interventions aimed at supporting the abortion providing workforce should likely assess abortion stigma. Stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue among abortion care providers. Therefore, strengthening human resources for abortion care requires stigma

Global action to reduce HIV stigma and discrimination

PubMed Central

Grossman, Cynthia I; Stangl, Anne L

2013-01-01

There is no question that the stigma and discrimination associated with HIV and AIDS can be reduced through intervention. The inclusion of stigma and discrimination reduction as a critical component of achieving an AIDS-free generation in recent UNAIDS, UN and PEPFAR political initiatives is promising. Yet national governments need evidence on effective interventions at the individual, community and societal levels in order to strategically incorporate stigma and discrimination reduction into national AIDS plans. Currently, the heterogeneity of stigma and discrimination reduction approaches and measurement makes it challenging to compare and contrast evaluated interventions. Moving forward, it is critical for the research community to: (1) clearly link intervention activities to the domains of stigma to be shifted; (2) assess the stigma domains in a consistent manner; and (3) link stigma and discrimination reduction with HIV prevention, care and treatment outcomes (e.g., uptake, adherence and retention of ART). These steps would further advance the scientific evidence base of stigma and discrimination reduction and allow for the identification of effective interventions that could be scaled up by national governments. PMID:24242269

Stigma for Seeking Therapy: Self-Stigma, Social Stigma, and Therapeutic Processes

ERIC Educational Resources Information Center

Owen, Jesse; Thomas, LeKeldric; Rodolfa, Emil

2013-01-01

The current study examined the associations among clients' perceptions of self- and social stigma for seeking help, session outcomes, and working alliance. Ninety-one clients were treated by 26 therapists, at a large university counseling center. All clients were currently in therapy. We expected that clients' perceptions of self- and social…

Predictors of HIV enacted stigma among Chilean women

PubMed Central

Cianelli, Rosina; Villlegas, Natalia; De Oliveira, Giovanna; Hires, Kimberly; Gattamorta, Karina; Ferrer, Lilian; Peragallo, Nilda

2015-01-01

Aims and objectives To investigate if socio-demographic factors, religiosity, HIV-related knowledge, Marianismo, history of having been tested for HIV, knowing someone who died of AIDS and HIV risk perception were predictive factors to HIV enacted stigma predictors among Chilean women. Background HIV infection is the number one cause of death among women during their reproductive years. In Chile, studies with people living with HIV demonstrate the existence of HIV-related stigma. However, limited evidence is available about the underlying causes of HIV enacted stigma that results in stigmatisation and discrimination. Design The current cross-sectional study is a secondary analysis of data collected to assess the impact of an HIV prevention intervention (Mano a Mano-Mujer) designed for Chilean women. A quasi-experimental design was used in the original study. Methods This study was conducted in two communities in Santiago, Chile. The sample for this study consisted of 496 Chileans between ages 18–49. Descriptive statistics and multiple regression were used for the analysis. Results Participants in the study reported high levels (77·8%) of HIV enacted stigma. Higher levels of HIV-related knowledge were associated with lower levels of HIV enacted stigma. Women with higher education had lower levels of HIV enacted stigma than women with elementary education. In addition, greater levels of marianismo (cultural belief that women should be passive, faithful, and devoted to family) were associated with higher HIV enacted stigma scores. Conclusions The findings reflected the presence of HIV enacted stigma among Chilean women. Identifying the significant predictors of HIV enacted stigma can help the nursing community to design HIV prevention interventions that include the reduction in HIV enacted stigma. HIV evidence-based prevention interventions should incorporate contents related to stigma to contribute to prevent HIV enacted stigma at individual and community levels

Predictors of HIV enacted stigma among Chilean women.

PubMed

Cianelli, Rosina; Villlegas, Natalia; De Oliveira, Giovanna; Hires, Kimberly; Gattamorta, Karina; Ferrer, Lilian; Peragallo, Nilda

2015-09-01

To investigate if socio-demographic factors, religiosity, HIV-related knowledge, Marianismo, history of having been tested for HIV, knowing someone who died of AIDS and HIV risk perception were predictive factors to HIV enacted stigma predictors among Chilean women. HIV infection is the number one cause of death among women during their reproductive years. In Chile, studies with people living with HIV demonstrate the existence of HIV-related stigma. However, limited evidence is available about the underlying causes of HIV enacted stigma that results in stigmatisation and discrimination. The current cross-sectional study is a secondary analysis of data collected to assess the impact of an HIV prevention intervention (Mano a Mano-Mujer) designed for Chilean women. A quasi-experimental design was used in the original study. This study was conducted in two communities in Santiago, Chile. The sample for this study consisted of 496 Chileans between ages 18-49. Descriptive statistics and multiple regression were used for the analysis. Participants in the study reported high levels (77·8%) of HIV enacted stigma. Higher levels of HIV-related knowledge were associated with lower levels of HIV enacted stigma. Women with higher education had lower levels of HIV enacted stigma than women with elementary education. In addition, greater levels of marianismo (cultural belief that women should be passive, faithful, and devoted to family) were associated with higher HIV enacted stigma scores. The findings reflected the presence of HIV enacted stigma among Chilean women. Identifying the significant predictors of HIV enacted stigma can help the nursing community to design HIV prevention interventions that include the reduction in HIV enacted stigma. HIV evidence-based prevention interventions should incorporate contents related to stigma to contribute to prevent HIV enacted stigma at individual and community levels in accordance with the bioecological model. The results of this study

Assessment of stigma associated with tuberculosis in Mexico.

PubMed

Moya, E M; Biswas, A; Chávez Baray, S M; Martínez, O; Lomeli, B

2014-12-21

Stigma is a major barrier to health care access and impacts the quality of life for individuals affected by tuberculosis (TB). Assessing TB stigma is essential to addressing health disparities. However, no such instrument was available in Mexico at the time of our study. This study examined the adaptability of the TB and human immunodeficiency virus (HIV) stigma scales previously used in Thailand. The original scale, developed in English, was linguistically adapted to Spanish and administered to 217 individuals affected by TB in five states in Mexico. The TB-HIV stigma subscales were designed to assess individual and community perspectives. Additional data collected included general information and socio-demographics. Assessment of psychometric properties included basic statistical tests, evaluation of Cronbach's alpha and factor analysis. We found no significant statistical differences associated with higher stigma scores by location, age, marital status, education and stigma scores. Factor analysis did not create any new factors. Internal consistency reliability coefficients were satisfactory (Cronbach α = 0.876-0.912). The use of the stigma scales has implications for 1) health improvements, 2) research on stigma and health disparities, and 3) TB and HIV stigma interventions. Further research is needed to examine transferability among larger and randomly selected Spanish-speaking populations.

Perceived stigma among individuals with common mental disorders.

PubMed

Alonso, Jordi; Buron, Andrea; Rojas-Farreras, Sonia; de Graaf, Ron; Haro, Josep M; de Girolamo, Giovanni; Bruffaerts, Ronny; Kovess, Viviane; Matschinger, Herbert; Vilagut, Gemma

2009-11-01

Severe mental disorders are associated with social distance from the general population, but there is lack of data on the stigma reported by individuals with common mental disorders. To identify the correlates and the impact of stigma among individuals with common mental disorders. Cross-sectional, household interview survey of 8796 representing the non-institutionalized adults of Belgium, France, Germany, Italy, the Netherlands and Spain. Two perceived stigma questions (embarrassment and discrimination) were asked to respondents with significant disability. Health-related quality of life measured by the SF-12, work and activity limitation and social limitation were also assessed. Among the 815 participants with a 12-month mental disorder and significant disability, 14.8% had perceived stigma. Stigma was significantly associated with low education, being married/living with someone and being unemployed. Perceived stigma was associated with decreased quality of life (SF-12 PCS score -4.65; p<0.05), higher work and role limitation and higher social limitation. Individuals with mental disorders are more likely to report stigma if they have lower education, are married, or are unemployed. Perceived stigma is associated with considerably decrease in quality of life and role functioning. Health professionals and society at large must be aware of these findings, which suggest that fighting stigma should be a public health priority.

The Stigma of Families with Mental Illness

ERIC Educational Resources Information Center

Larson, Jon E.; Corrigan, Patrick

2008-01-01

Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

Reducing Susceptibility to Courtesy Stigma.

PubMed

Bachleda, Catherine L; El Menzhi, Leila

2018-06-01

In light of the chronic shortage of health professionals willing to care for HIV/AIDS patients, and rising epidemics in many Muslim countries, this qualitative study examined susceptibility and resistance to courtesy stigma as experienced by nurses, doctors, and social workers in Morocco. Forty-nine in-depth interviews provided rich insights into the process of courtesy stigma and how it is managed, within the context of interactions with Islam, interactions within the workplace (patients, other health professionals), and interactions outside the workplace (the general public, friends, and family). Theoretically, the findings extend understanding of courtesy stigma and the dirty work literature. The findings also offer practical suggestions for the development of culturally appropriate strategies to reduce susceptibility to courtesy stigmatization. This study represents the first to explore courtesy stigma as a process experienced by health professionals providing HIV/AIDS care in an Islamic country.

Development of the Family Stigma Stress Scale (FSSS) for Detecting Stigma Stress in Caregivers of People With Mental Illness.

PubMed

Chang, Chih-Cheng; Su, Jian-An; Chang, Kun-Chia; Lin, Chung-Ying; Koschorke, Mirja; Rüsch, Nicolas; Thornicroft, Graham

2017-01-01

People with mental illness and their family caregivers often perceive public stigma, which may lead to stigma-related stress (or stigma stress). However, no instruments have been developed to measure this stress for family caregivers of people with mental illness. We modified an instrument that measures the stigma stress of people with mental illness (i.e., the cognitive appraisal of stigma as a stressor) and examined the psychometric properties of the scores of the newly developed instrument: the Family Stigma Stress Scale (FSSS). Primary family caregivers of people with mental illness in Southern Taiwan ( n = 300; mean age = 53.08 ± 13.80; 136 males) completed the FSSS. An exploratory factor analysis showed that the FSSS score had two factors; both factor scores had excellent internal consistency (α = .913 and .814) and adequate test-retest reliability ( r = .627 and .533; n = 197). Significant correlations between FSSS factor scores and other instruments supported its concurrent validity and the ability of the FSSS to differentiate between clinical characteristics, for example, having been previously hospitalized or not. The FSSS is a brief and effective measure of the stigma stress of family caregivers of people with mental illness.

Intersectionality: An Understudied Framework for Addressing Weight Stigma.

PubMed

Himmelstein, Mary S; Puhl, Rebecca M; Quinn, Diane M

2017-10-01

Obesity is an ongoing public health concern in the U.S. Weight stigma is linked to a number of obesogenic health outcomes, which complicate obesity treatment and prevention. Despite higher rates of obesity in female and minority populations, little research has examined weight stigma in non-white women and men. This study investigated intersectionality in weight stigma and health-related coping responses to stigmatizing experiences across racial groups. In 2015, a total of 2,378 adults completed questionnaires about weight stigma, weight bias internalization, and coping strategies. Analyses were conducted in 2016. No differences in weight stigma emerged as a function of race or gender, but women reported higher weight bias internalization (B=0.19, p=0.004). Further, black men and women reported less weight bias internalization than white men and women (B=-0.43, p=0.009). Compared with white women, black women were less likely to cope with stigma using disordered eating (B=-0.57, p=0.001), whereas Hispanic women were more likely to cope with stigma using disordered eating (B=0.39, p=0.020). Black men were more likely than white men to cope with stigma via eating (B=-0.49, p=0.017). Findings highlight that weight stigma is equally present across racial groups, but that groups internalize and cope with stigma in different ways, which exacerbate health risks. Increased research and policy attention should address stigma as an obstacle in prevention and treatment for obesity to reduce weight-based inequities in underserved populations. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Exploring the Concept of HIV-Related Stigma

PubMed Central

Florom-Smith, Aubrey L.; De Santis, Joseph P.

2013-01-01

BACKGROUND HIV infection is a chronic, manageable illness. Despite advances in the care and treatment of people living with HIV infection, HIV-related stigma remains a challenge to HIV testing, care, and prevention. Numerous studies have documented the impact of HIV-related stigma among various groups of people living with HIV infection, but the concept of HIV-related stigma remains unclear. PURPOSE Concept exploration of HIV-related stigma via an integrative literature review was conducted in order to examine the existing knowledge base of this concept. METHODS Search engines were employed to review the existing knowledge base of this concept. CONCLUSION After the integrative literature review, an analysis of HIV-related stigma emerged. Implications for future concept analysis, research, and practice are included. PMID:22861652

Stigma towards PLWHA: The Role of Internalized Homosexual Stigma in Latino Gay/Bisexual Male and Transgender Communities

PubMed Central

Ramirez-Valles, Jesus; Molina, Yamile; Dirkes, Jessica

2013-01-01

Stigma negatively affects the health of people living with HIV/AIDS (PLWHA). Negative attitudes and discriminatory actions towards PLWHA are thought to be based, among other factors, on stigma towards sexual minorities and beliefs about personal responsibility. Yet, there is little evidence to support these linkages and explain how they take place, especially among Latinos. This study analyzes attitudes towards PLWHA among 643 Latino gay/bisexual men and transgender (GBT) people. It examines whether discriminatory actions are predicted by beliefs about personal responsibility and internalized homosexual stigma. Results indicate that Discriminatory Actions towards PLWHA is associated with HIV/AIDS Personal Responsibility Beliefs and Internalized Homosexual Stigma. Further, HIV/AIDS Personal Responsibility Beliefs partially mediates the relationship between Internalized Homosexual Stigma and Discriminatory Actions towards PLWHA. Latino GBT persons who have internalized negative views about homosexuality may project those onto PLWHA. They may think PLWHA are responsible for their serostatus and, hence, deserving of rejection. PMID:23631713

Stigma towards PLWHA: the role of internalized homosexual stigma in Latino gay/bisexual male and transgender communities.

PubMed

Ramirez-Valles, Jesus; Molina, Yamile; Dirkes, Jessica

2013-06-01

Stigma negatively affects the health of people living with HIV/AIDS (PLWHA). Negative attitudes and discriminatory actions towards PLWHA are thought to be based, among other factors, on stigma towards sexual minorities and beliefs about personal responsibility. Yet, there is little evidence to support these linkages and explain how they take place, especially among Latinos. This study analyzes attitudes towards PLWHA among 643 Latino gay/bisexual men and transgender (GBT) people. It examines whether discriminatory actions are predicted by beliefs about personal responsibility and internalized homosexual stigma. Results indicate that Discriminatory Actions towards PLWHA is associated with HIV/AIDS Personal Responsibility Beliefs and Internalized Homosexual Stigma. Further, HIV/AIDS Personal Responsibility Beliefs partially mediates the relationship between Internalized Homosexual Stigma and Discriminatory Actions towards PLWHA. Latino GBT persons who have internalized negative views about homosexuality may project those onto PLWHA. They may think PLWHA are responsible for their serostatus and, hence, deserving of rejection.

Legal Change and Stigma in Surrogacy and Abortion.

PubMed

Robertson, John A

2015-01-01

Stigma marks both surrogacy and abortion. Legal change lessens stigma but may not remove it altogether. Post-legalization regulation may reinstall stigma by surrounding a legalized practice with barriers that make exercise of that right more difficult. As a result, law may reenact stigma even as it purports to take it away. © 2015 American Society of Law, Medicine & Ethics, Inc.

Stigma-Stop: A Serious Game against the Stigma toward Mental Health in Educational Settings

PubMed Central

Cangas, Adolfo J.; Navarro, Noelia; Parra, José M. A.; Ojeda, Juan J.; Cangas, Diego; Piedra, Jose A.; Gallego, Jose

2017-01-01

This paper presents the results from the application of a serious game called Stigma-Stop among a group of high school students with the aim of reducing the stigma toward mental illnesses. The video game features characters with various mental disorders (schizophrenia, depression, bipolar disorder, and panic disorder with agoraphobia) and provides information about these problems. Additionally, the game asks players about whether they have ever felt the same as the characters, if they believe the characters are psychologically well, and if they think they could help these individuals. Similarly, a variety of reactions are provided for players to choose from when they encounter the characters with these problems. A total of 552 students between the ages of 14 and 18 participated in the study, and they were randomly assigned to either the experimental group, which used Stigma-Stop, or the control group, which utilized a video game completely unrelated to mental health. Both video games were used for similar lengths of time. Following the application of Stigma-Stop, a statistically significant decrease was obtained in levels of stigma toward schizophrenia, both in terms of stereotypes and, to a greater extent, its potential dangerousness. However, this was not the case in the control group. Results thus demonstrate the video game’s usefulness toward eradicating erroneous notions about serious mental disorders like schizophrenia. PMID:28878702

Stigma-Stop: A Serious Game against the Stigma toward Mental Health in Educational Settings.

PubMed

Cangas, Adolfo J; Navarro, Noelia; Parra, José M A; Ojeda, Juan J; Cangas, Diego; Piedra, Jose A; Gallego, Jose

2017-01-01

This paper presents the results from the application of a serious game called Stigma-Stop among a group of high school students with the aim of reducing the stigma toward mental illnesses. The video game features characters with various mental disorders (schizophrenia, depression, bipolar disorder, and panic disorder with agoraphobia) and provides information about these problems. Additionally, the game asks players about whether they have ever felt the same as the characters, if they believe the characters are psychologically well, and if they think they could help these individuals. Similarly, a variety of reactions are provided for players to choose from when they encounter the characters with these problems. A total of 552 students between the ages of 14 and 18 participated in the study, and they were randomly assigned to either the experimental group, which used Stigma-Stop, or the control group, which utilized a video game completely unrelated to mental health. Both video games were used for similar lengths of time. Following the application of Stigma-Stop, a statistically significant decrease was obtained in levels of stigma toward schizophrenia, both in terms of stereotypes and, to a greater extent, its potential dangerousness. However, this was not the case in the control group. Results thus demonstrate the video game's usefulness toward eradicating erroneous notions about serious mental disorders like schizophrenia.

Stigma of epilepsy.

PubMed

Bandstra, Nancy F; Camfield, Carol S; Camfield, Peter R

2008-09-01

Epilepsy directly affects 50 million people worldwide. Most can achieve excellent seizure control; however, people living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions and misunderstandings that have persisted for thousands of years. This paper reviews the frequency and nature of stigma toward epilepsy. Significant negative attitudes prevail in the adolescent and adult public worldwide leading to loneliness and social avoidance both in school and in the workplace. People with epilepsy are often wrongly viewed as having mental health and antisocial issues and as being potentially violent toward others. Twenty-five percent of adults having epilepsy describe social stigma as a result of their epilepsy. They fear rejection and often feel shame or loneliness from this diagnosis. The psychosocial and social impact of epilepsy is significant. Yet few specific interventions have been demonstrated to alter this perception. The effect on public education is primarily short-term, while change over the long-term in attitudes and inaccurate beliefs have not presently been proven effective. School education programming demonstrates improved knowledge and attitude a month after a classroom intervention, but persisting change over a longer period of time has not been evaluated. In-depth adult psycho-educational programs for adults with epilepsy improves knowledge, coping skills and level of felt stigma. However these gains have not demonstrated persistence over time. Myths, misconceptions and misunderstandings about epilepsy continue and programs aimed at increasing knowledge and reducing negative public attitudes should be enhanced.

The Stigma of Mental Illness and Recovery.

PubMed

Avdibegović, Esmina; Hasanović, Mevludin

2017-12-01

Stigma and recovery "from" and "in" mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination. The recovery of a person with mental illness means to get and keep hope, to understand their own possibilities and impossibilities, active living, to be autonomous, to have a social identity and to give meaning and purpose of our own lives. The care system, recovery-oriented, provides help and support to people with mental disorders in his/her recovery, which contributes to reduction of self-stigma, to the elimination of stigmatizing attitudes and beliefs in mental health services which consequently may have a positive reflection in reducing the stigma of mental illness in the community. It is important to look at the stigma and recovery from the perspective of individual experience of each person with a mental illness in the process of recovery. A support to the recovery concept and the development of a recovery-oriented system of care should be one of the key segments of any strategy to combat the stigma of mental illness. Also, the cultural and the social stigma aspects of stigma would be taken into account in the developing of the recovery concept and on the recovery-oriented care system.

Stigma consciousness: the psychological legacy of social stereotypes.

PubMed

Pinel, E C

1999-01-01

Whereas past researchers have treated targets of stereotypes as though they have uniform reactions to their stereotyped status (e.g., J. Crocker & B. Major, 1989; C. M. Steele & J. Aronson, 1995), it is proposed here that targets differ in the extent to which they expect to be stereotyped by others (i.e., stigma consciousness). Six studies, 5 of which validate the stigma-consciousness questionnaire (SCQ), are presented. The results suggest that the SCQ is a reliable and valid instrument for detecting differences in stigma consciousness. In addition, scores on the SCQ predict perceptions of discrimination and the ability to generate convincing examples of such discrimination. The final study highlights a behavioral consequence of stigma consciousness: the tendency for people high in stigma consciousness to forgo opportunities to invalidate stereotypes about their group. The relation of stigma consciousness to past research on targets of stereotypes is considered as is the issue of how stigma consciousness may encourage continued stereotyping.

Parents with serious mental illness: differences in internalised and externalised mental illness stigma and gender stigma between mothers and fathers.

PubMed

Lacey, Melanie; Paolini, Stefania; Hanlon, Mary-Claire; Melville, Jessica; Galletly, Cherrie; Campbell, Linda E

2015-02-28

Research demonstrates that people living with serious mental illness (SMI) contend with widespread public stigma; however, little is known about the specific experiences of stigma that mothers, and in particular fathers, with SMI encounter as parents. This study aimed to explore and compare the experiences of stigma for mothers and fathers with SMI inferred not only by living with a mental illness but also potential compounding gender effects, and the associated impact of stigma on parenting. Telephone surveys were conducted with 93 participants with SMI who previously identified as parents in the Second Australian National Survey of Psychosis. Results indicated that mothers were more likely than fathers to perceive and internalise stigma associated with their mental illness. Conversely, fathers were more inclined to perceive stigma relating to their gender and to hold stigmatising attitudes towards others. Mental illness and gender stigma predicted poorer self-reported parenting experiences for both mothers and fathers. These findings may assist in tailoring interventions for mothers and fathers with SMI. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The Maristán stigma scale: a standardized international measure of the stigma of schizophrenia and other psychoses.

PubMed

Saldivia, Sandra; Runte-Geidel, Ariadne; Grandón, Pamela; Torres-González, Francisco; Xavier, Miguel; Antonioli, Claudio; Ballester, Dinarte A; Melipillán, Roberto; Galende, Emiliano; Vicente, Benjamín; Caldas, José Miguel; Killaspy, Helen; Gibbons, Rachel; King, Michael

2014-06-18

People with schizophrenia face prejudice and discrimination from a number of sources including professionals and families. The degree of stigma perceived and experienced varies across cultures and communities. We aimed to develop a cross-cultural measure of the stigma perceived by people with schizophrenia. Items for the scale were developed from qualitative group interviews with people with schizophrenia in six countries. The scale was then applied in face-to-face interviews with 164 participants, 103 of which were repeated after 30 days. Principal Axis Factoring and Promax rotation evaluated the structure of the scale; Horn's parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability. The final scale has 31 items and four factors: informal social networks, socio-institutional, health professionals and self-stigma. Cronbach's alpha was 0.84 for the Factor 1; 0.81 for Factor 2; 0.74 for Factor 3, and 0.75 for Factor 4. Correlation matrix among factors revealed that most were in the moderate range [0.31-0.49], with the strongest occurring between perception of stigma in the informal network and self-stigma and there was also a weaker correlation between stigma from health professionals and self-stigma. Test-retest reliability was highest for informal networks [ICC 0.76 [0.67 -0.83

The Maristán stigma scale: a standardized international measure of the stigma of schizophrenia and other psychoses

PubMed Central

2014-01-01

Background People with schizophrenia face prejudice and discrimination from a number of sources including professionals and families. The degree of stigma perceived and experienced varies across cultures and communities. We aimed to develop a cross-cultural measure of the stigma perceived by people with schizophrenia. Method Items for the scale were developed from qualitative group interviews with people with schizophrenia in six countries. The scale was then applied in face-to-face interviews with 164 participants, 103 of which were repeated after 30 days. Principal Axis Factoring and Promax rotation evaluated the structure of the scale; Horn’s parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability. Results The final scale has 31 items and four factors: informal social networks, socio-institutional, health professionals and self-stigma. Cronbach’s alpha was 0.84 for the Factor 1; 0.81 for Factor 2; 0.74 for Factor 3, and 0.75 for Factor 4. Correlation matrix among factors revealed that most were in the moderate range [0.31-0.49], with the strongest occurring between perception of stigma in the informal network and self-stigma and there was also a weaker correlation between stigma from health professionals and self-stigma. Test-retest reliability was highest for informal networks [ICC 0.76 [0.67 -0.83

Stigma of Mental Illness-1: Clinical reflections

PubMed Central

Shrivastava, Amresh; Johnston, Megan; Bureau, Yves

2012-01-01

Although the quality and effectiveness of mental health treatments and services have improved greatly over the past 50 years, therapeutic revolutions in psychiatry have not yet been able to reduce stigma. Stigma is a risk factor leading to negative mental health outcomes. It is responsible for treatment seeking delays and reduces the likelihood that a mentally ill patient will receive adequate care. It is evident that delay due to stigma can have devastating consequences. This review will discuss the causes and consequences of stigma related to mental illness. PMID:22654383

Combating Stigma Resulting from Deformity and Disease.

ERIC Educational Resources Information Center

Leonard Wood Memorial for the Eradication of Leprosy, New York, NY.

Summarized are the proceedings of a seminar concerned with methods of combating stigma resulting from facial disfigurement, epilepsy, cerebral palsy, and leprosy. The purpose was to determine how theories about stigma can help in the development of new methods of public education in order to change public attitudes and reduce social stigma.…

Understanding the Importance of “Symbolic Interaction Stigma:” How Expectations about the Reactions of Others Adds to the Burden of Mental illness Stigma

PubMed Central

Link, Bruce G.; Wells, Jennifer; Phelan, Jo C.; Yang, Lawrence

2017-01-01

Objective Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called “symbolic interaction stigma” and can be impactful even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced and a preliminary assessment of their impact provided. Methods Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N=65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem and isolation from relatives independent of measures of internalization of stigma and rejection experiences. Results As evidenced by scores on four distinct measures symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. Additionally, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. Conclusions and Implications for Practice The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed. PMID:26075528

[Stigma of "madness" from fate to recovery].

PubMed

Bonsack, C; Morandi, S; Favrod, J; Conus, P

2013-03-13

Stigma is a "natural" social reaction, partly unconscious and automatic towards "different" and "vulnerable" populations. Suspicion of danger, unemployment, excluded from society, locked in hospital, assaulted or killed are the possible consequences of mental disorders' stigma. Despite advances in psychiatric treatments, the stigma of the "madness" remains a barrier to access to recovery. The stigmatization process is more complex than simple labeling, and leads to discrimination and loss of social power. Understanding the mechanisms of stigmatization can determine targets for effective interventions to fight stigma at the individual, institutional and political levels. The roles of patient and family associations, as well as the recovery model for the professionals, are essential. The aim of this article is to review the various aspects of mental disorders' stigma and to examine ways to cope with them.

Detecting depression stigma on social media: A linguistic analysis.

PubMed

Li, Ang; Jiao, Dongdong; Zhu, Tingshao

2018-05-01

Efficient detection of depression stigma in mass media is important for designing effective stigma reduction strategies. Using linguistic analysis methods, this paper aims to build computational models for detecting stigma expressions in Chinese social media posts (Sina Weibo). A total of 15,879 Weibo posts with keywords were collected and analyzed. First, a content analysis was conducted on all 15,879 posts to determine whether each of them reflected depression stigma or not. Second, using four algorithms (Simple Logistic Regression, Multilayer Perceptron Neural Networks, Support Vector Machine, and Random Forest), two groups of classification models were built based on selected linguistic features; one for differentiating between posts with and without depression stigma, and one for differentiating among posts with three specific types of depression stigma. First, 967 of 15,879 posts (6.09%) indicated depression stigma. 39.30%, 15.82%, and 14.99% of them endorsed the stigmatizing view that "People with depression are unpredictable", "Depression is a sign of personal weakness", and "Depression is not a real medical illness", respectively. Second, the highest F-Measure value for differentiating between stigma and non-stigma reached 75.2%. The highest F-Measure value for differentiating among three specific types of stigma reached 86.2%. Due to the limited and imbalanced dataset of Chinese Weibo posts, the findings of this study might have limited generalizability. This paper confirms that incorporating linguistic analysis methods into online detection of stigma can be beneficial to improve the performance of stigma reduction programs. Copyright © 2018 Elsevier B.V. All rights reserved.

Child Welfare and Stigma: Principles into Practice.

ERIC Educational Resources Information Center

Colton, Matthew; And Others

1997-01-01

Investigated the stigma attached to child welfare services in the Netherlands, United Kingdom, and Spain. Found that stigma continues to be part of the experience of using and delivering such services, despite positive determination of policies in all three countries that this should not be so. Also found that the experience of stigma can, with…

Total antioxidant capacity of spices, dried fruits, nuts, pulses, cereals and sweets consumed in Italy assessed by three different in vitro assays.

PubMed

Pellegrini, Nicoletta; Serafini, Mauro; Salvatore, Sara; Del Rio, Daniele; Bianchi, Marta; Brighenti, Furio

2006-11-01

With the aim to expand the Italian total antioxidant capacity (TAC) database, the TAC values of 11 spices, 5 dried fruits, 7 sweets, 18 cereal products, 5 pulses, and 6 nuts were determined using three different assays and considering the contribution of bound antioxidant compounds in fiber-rich foods (i. e. cereals, legumes, and nuts). Among spices, saffron displayed the highest antioxidant capacity, whereas among dried fruits, prune exhibited the highest value. The TAC values of all the chocolates analyzed were far higher than the other sweet extracts measured. Among cereal products, whole meal buckwheat and wheat bran had the greatest TAC. Among pulses and nuts, broad bean, lentil and walnuts had the highest antioxidant capacity, whereas chickpeas, pine nuts and peanuts were less effective. The contribution of bound phytochemicals to the overall TAC was relevant in cereals as well as in nuts and pulses. The complete TAC database could be utilized to properly investigate the role of dietary antioxidants in disease prevention.

Stigma predicts residential treatment length for substance use disorder

PubMed Central

Luoma, Jason B.; Kulesza, Magdalena; Hayes, Steven C.; Kohlenberg, Barbara; Larimer, Mary

2016-01-01

Background Stigma has been suggested as a possible contributor to the high rates of treatment attrition in substance-dependent individuals, but no published empirical studies have examined this association. Objectives The present paper assessed the relationship between baseline stigma variables and length of treatment stay in a sample of patients in a residential addictions treatment unit. Methods The relationship between baseline stigma variables (self-stigma, enacted stigma, and shame) and length of stay for participants (n = 103) in a residential addictions treatment unit was examined. Results Higher self-stigma predicted longer stay in residential addictions treatment, even after controlling for age, marital status, race, overall mental health, social support, enacted stigma, and internalized shame. However, other stigma variables (i.e. internalized shame, stigma-related rejection) did not reliably predict length of treatment stay. Conclusion These results are consistent with other findings suggesting that people with higher self-stigma may have a lowered sense of self-efficacy and heightened fear of being stigmatized and therefore retreat into more protected settings such as residential treatment, potentially resulting in higher treatment costs. Specialized clinical interventions may be necessary to help participants cope with reduced self-efficacy and fear of being stigmatized. PMID:24766087

Changing public stigma with continuum beliefs.

PubMed

Corrigan, Patrick W; Schmidt, Annie; Bink, Andrea B; Nieweglowski, Katherine; Al-Khouja, Maya A; Qin, Sang; Discont, Steve

2017-10-01

Given the egregious effect of public stigma on the lives of people with mental illness, researchers have sought to unpack and identify effective components of anti-stigma programs. We expect to show that continuum messages have more positive effect on stigma and affirming attitudes (beliefs that people with mental illness recover and should be personally empowered) than categorical perspectives. The effect of continuum beliefs will interact with contact strategies. A total of 598 research participants were randomly assigned to online presentations representing one of the six conditions: three messages (continuum, categorical, or neutral control) by two processes (education or contact). Participants completed measures of continuum beliefs (as a manipulation check), stigma and affirming attitudes after viewing the condition. Continuum messages had significantly better effect on views that people with mental illness are "different," a finding that interacted with contact. Continuum messages also had better effects on recovery beliefs, once again an effect that interacted significantly with contact. Implications of these findings for improving anti-stigma programs are discussed.

Exploring diabetes type 1-related stigma.

PubMed

Abdoli, Samereh; Abazari, Parvaneh; Mardanian, Leila

2013-01-01

Empowerment of people with diabetes means integrating diabetes with identity. However, others' stigmatization can influence it. Although diabetes is so prevalent among Iranians, there is little knowledge about diabetes-related stigma in Iran. The present study explored diabetes-related stigma in people living with type 1 diabetes in Isfahan. A conventional content analysis was used with in-depth interview with 26 people with and without diabetes from November 2011 to July 2012. A person with type 1 diabetes was stigmatized as a miserable human (always sick and unable, death reminder, and intolerable burden), rejected marriage candidate (busy spouse, high-risk pregnant), and deprived of a normal life [prisoner of (to must), deprived of pleasure]. Although, young adults with diabetes undergo all aspects of the social diabetes-related stigma; in their opinion they were just deprived of a normal life. It seems that in Isfahan, diabetes-related stigma is of great importance. In this way, conducting an appropriate intervention is necessary to improve the empowerment process in people with type 1 diabetes in order to reduce the stigma in the context.

Mental health stigma: what is being done to raise awareness and reduce stigma in South Africa?

PubMed

Kakuma, R; Kleintjes, S; Lund, C; Drew, N; Green, A; Flisher, A J

2010-05-01

Stigma plays a major role in the persistent suffering, disability and economic loss associated with mental illnesses. There is an urgent need to find effective strategies to increase awareness about mental illnesses and reduce stigma and discrimination. This study surveys the existing anti-stigma programmes in South Africa. The World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 and semi-structured interviews were used to collect data on mental health education programmes in South Africa. Numerous anti-stigma campaigns are in place in both government and non-government organizations across the country. All nine provinces have had public campaigns between 2000 and 2005, targeting various groups such as the general public, youth, different ethnic groups, health care professionals, teachers and politicians. Some schools are setting up education and prevention programmes and various forms of media and art are being utilized to educate and discourage stigma and discrimination. Mental health care users are increasingly getting involved through media and talks in a wide range of settings. Yet very few of such activities are systematically evaluated for the effectiveness and very few are being published in peer-review journals or in reports where experiences and lessons can be shared and potentially applied elsewhere. A pool of evidence for anti-stigma and awareness-raising strategies currently exists that could potentially make a scientific contribution and inform policy in South Africa as well as in other countries.

SELF-STIGMA AND COMING OUT ABOUT ONE'S MENTAL ILLNESS.

PubMed

Corrigan, Patrick W; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rüsch, Nicolas

2010-04-01

Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person's quality of life are discussed.

Stigma Experienced by Children and Adolescents With Obesity.

PubMed

Pont, Stephen J; Puhl, Rebecca; Cook, Stephen R; Slusser, Wendelin

2017-12-01

The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting. Copyright © 2017 by the American Academy of Pediatrics.

Overcoming HIV Stigma? A Qualitative Analysis of HIV Cure Research and Stigma Among Men Who Have Sex with Men Living with HIV.

PubMed

Wu, Feng; Zhang, Alice; Babbitt, Andrew; Ma, Qingyan; Eyal, Nir; Pan, Xin; Cai, Weiping; Hu, Fengyu; Cheng, Yu; Tucker, Joseph D

2017-11-17

Despite global progress in HIV stigma reduction, persistent HIV stigma thwarts effective HIV service delivery. Advances in HIV biomedical research toward a cure may shift perceptions of people living with HIV and HIV stigma. The purpose of this study was to examine how men who have sex with men (MSM) living with HIV in Guangzhou, China perceive HIV cure research and its potential impact on MSM and HIV stigma. We conducted in-depth interviews with 26 MSM living with HIV about their perceptions of HIV cure research and the potential impact of an HIV cure on their lives. Thematic coding was used to identify themes and structure the analysis. Two overarching themes emerged. First, participants stated that an HIV cure may have a limited impact on MSM-related stigma. Men noted that most stigma toward MSM was linked to stereotypes of promiscuity and high rates of sexual transmitted diseases in the MSM community and might persist even after a cure. Second, participants believed that an HIV cure could substantially reduce enacted, anticipated, and internalized stigma associated with HIV. These findings suggest that a biomedical cure alone would not remove the layered stigma facing MSM living with HIV. Comprehensive measures to reduce stigma are needed.

The nature and impact of stigma towards injured workers.

PubMed

Kirsh, Bonnie; Slack, Tesha; King, Carole Anne

2012-06-01

Many injured workers experience high levels of stigma and discrimination, which compound their physical injuries and cause social and psychological harm. Despite a growing awareness of the prevalence of such stigma, there is little research that focuses on the sources, nature and consequences of stigma with respect to the lives of injured workers. The purpose of this paper is to advance knowledge related to stigma towards injured workers, specifically to explain the nature and processes of stigma and their influence on injured workers' lives. Using a constructivist grounded theory approach, data from focus groups (n = 28 participants) and individual interviews (n = 18) were analyzed to discern how stigma is exhibited and perpetuated, and its impact on the lives of injured workers. The study culminated in a preliminary theoretical framework that delineates the key components of the manifestations and impacts of stigma that includes stereotypes, unethical practices and maltreatment negatively affecting work, relationships and the mental health of injured workers. The development of sound conceptualizations in this area can advance our understanding of stigma processes and provide a framework for anti-stigma efforts. The findings have implications for public education, workplace interventions and services for injured workers.

Best practices: Strategic stigma change (SSC): five principles for social marketing campaigns to reduce stigma.

PubMed

Corrigan, Patrick W

2011-08-01

This column describes strategic stigma change (SSC), which comprises five principles and corresponding practices developed as a best practice to erase prejudice and discrimination associated with mental illness and promote affirming behaviors and social inclusion. SSC principles represent more than ten years of insights from the National Consortium on Stigma and Empowerment. The principles, which are centered on consumer contact that is targeted, local, credible, and continuous, were developed to inform the growth of large-scale social marketing campaigns supported by governments and nongovernmental organizations. Future social marketing efforts to address stigma and the need for evidence to determine SSC's penetration and impact are also discussed.

Teenage Mothers' Experiences of Stigma

ERIC Educational Resources Information Center

Yardley, Elizabeth

2008-01-01

This article is concerned with exploring the impact of stigma upon teenage mothers. Drawing upon the findings of in-depth interviews with 20 teenage mothers, the study explores the ways and contexts within which stigma is experienced and identifies differential effects and coping mechanisms reported by the participants. Thereafter, it is suggested…

Stigma and Racial/Ethnic HIV Disparities: Moving Toward Resilience

PubMed Central

Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, Davird R.

2013-01-01

Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce the Stigma and HIV Disparities Model to describe how societal stigma related to race and ethnicity is associated with racial/ethnic HIV disparities via its manifestations at the structural level (e.g., residential segregation) as well as the individual level among perceivers (e.g., discrimination) and targets (e.g., internalized stigma). We then review evidence of these associations. Because racial/ethnic minorities at risk of and living with HIV often possess multiple stigmas (e.g., HIV-positive, substance use), we adopt an intersectionality framework and conceptualize interdependence among co-occurring stigmas. We further propose a resilience agenda and suggest that intervening on modifiable strength-based moderators of the association between societal stigma and disparities can reduce disparities. Strengthening economic and community empowerment and trust at the structural level, creating common ingroup identities and promoting contact with people living with HIV among perceivers at the individual level, and enhancing social support and adaptive coping among targets at the individual level can improve resilience to societal stigma and ultimately reduce racial/ethnic HIV disparities. PMID:23688090

Stigma and intellectual disability: potential application of mental illness research.

PubMed

Ditchman, Nicole; Werner, Shirli; Kosyluk, Kristin; Jones, Nev; Elg, Brianna; Corrigan, Patrick W

2013-05-01

Individuals with intellectual disabilities (ID) and individuals with mental illness are consistently found to be among the most socially excluded populations and continue to face substantial health, housing, and employment disparities due to stigma. Although this has spurred extensive research efforts and theoretical advancements in the study of stigma toward mental illness, the stigma of ID has received only limited attention. In this article we explore the application of mental illness stigma research for ID. We carefully reviewed the existing research on mental illness stigma as a foundation for a parallel summary of the empirical literature on attitudes and stigma related to ID. Based on our review, there has not been a systematic approach to the study of stigma toward ID. However, multilevel conceptual models of stigma have received much attention in the mental illness literature. These models have been used to inform targeted interventions and have application to the study of the stigma process for individuals with ID. Nonetheless, there are indeed key differences between-as well as substantial variability within-the ID and mental illness populations that must be considered. Stigma is an issue of social justice impacting the lives of individuals with ID, yet there remains virtually no systematic framework applied to the understanding of the stigma process for this group. Future research can draw on the stigma models developed in the mental illness literature to guide more rigorous research efforts and ultimately the development of effective, multilevel stigma-change strategies for ID.

Does the stigma of mental illness contribute to suicidality?

PubMed

Rüsch, Nicolas; Zlati, Alina; Black, Georgia; Thornicroft, Graham

2014-10-01

Mental disorders are associated with suicidality and with stigma. Many consequences of stigma, such as social isolation, unemployment, hopelessness or stress, are risk factors for suicidality. Research is needed on the link between stigma and suicidality as well as on anti-stigma interventions and their effects on suicidality. Royal College of Psychiatrists.

Evaluation of Abortion Stigma in the Workforce: Development of the Revised Abortion Providers Stigma Scale.

PubMed

Martin, Lisa A; Hassinger, Jane A; Seewald, Meghan; Harris, Lisa H

We report on the development of a scale measuring abortion providers' experiences of stigma. Using previous measures, qualitative data, and expert review, we created a 49-item question pool. We administered questions to 315 abortion providers before participation in the Providers Share Workshop. We explored the factor structure and item quality using exploratory factor analysis. We assessed reliability using Cronbach's alpha. To test construct validity, we calculated Pearson's correlation coefficients between the stigma scales, the Maslach Burnout Inventory, and the K10 measure of psychological distress. We used Stata SE/12.0 for analyses. Factor analysis revealed a 35-item, five-factor model: worries about disclosure, internalized states, social judgment, social isolation, and discrimination (Cronbach's alphas 0.79-0.94). Our stigma measure was correlated with psychological distress (r = 0.40; p < .001), and with Maslach Burnout Inventory's emotional exhaustion (r = 0.27; p < .001), and depersonalization (0.23; p < .001) subscales, and was inversely correlated with Maslach Burnout Inventory's personal accomplishment subscale (r = -0.15; p < .05). Psychometric analysis of this scale reveals that it is a reliable and valid tool for measuring stigma in abortion providers, and may be helpful in evaluating stigma reduction programs. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Mental Illness Sexual Stigma: Implications for Health and Recovery

PubMed Central

Wainberg, Milton L.; Cournos, Francine; Wall, Melanie M.; Pala, Andrea Norcini; Mann, Claudio Gruber; Pinto, Diana; Pinho, Veronica; McKinnon, Karen

2015-01-01

Objective Among people in psychiatric care worldwide, the majority is sexually active, and sharply elevated rates of HIV infection compared to the general population have been shown. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Method 641 sexually active adults attending eight public outpatient psychiatric clinics in Rio de Janeiro were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Results Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on Individual Discrimination and Structural Stigma mechanisms than those with non-severe mental illness diagnoses, while there was no difference on the Social Psychological Processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Conclusions and Implications for Practice Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examining the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability. PMID:27030909

Mental illness sexual stigma: Implications for health and recovery.

PubMed

Wainberg, Milton L; Cournos, Francine; Wall, Melanie M; Norcini Pala, Andrea; Mann, Claudio Gruber; Pinto, Diana; Pinho, Veronica; McKinnon, Karen

2016-06-01

The majority of people in psychiatric care worldwide are sexually active, and studies have revealed sharply elevated rates of HIV infection in that group compared with the general population. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Sexually active adults attending 8 public outpatient psychiatric clinics in Rio de Janeiro (N = 641) were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well-established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on individual discrimination and structural stigma mechanisms than did those with nonsevere mental illness diagnoses, whereas there was no difference on the social psychological processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examinations of the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Randomized study of different anti-stigma media.

PubMed

Finkelstein, Joseph; Lapshin, Oleg; Wasserman, Evgeny

2008-05-01

We designed our study to assess if computer-assisted anti-stigma interventions can be effective in reducing the level of psychiatric stigma in a sample of special education university students. We enrolled 193 graduate students. They had two study visits with an interval of 6 months. The participants were randomly distributed into three study groups: 76 students read anti-stigma printed materials (reading group, RG), and 69 studied an anti-stigma computer program (program group, PG), and 48 students were in a control group (CG) and received no intervention. We used the Bogardus scale of social distance (BSSD), the community attitudes toward the mentally ill (CAMI) questionnaire, and the psychiatric knowledge survey (PKS) as the main outcome measures. After the intervention BSSD, CAMI and PKS scores significantly improved both in RG and PG. After 6 months in RG two out of three CAMI subscales and PKS scores were not different from the baseline. In PG all stigma and knowledge changes remained significant. This study demonstrated that computers can be an effective mean in changing attitudes of students toward psychiatric patients. A computer-mediated intervention has the potential for educating graduate students about mental disease and for reducing psychiatric stigma.

The Stigma Resistance Scale: A multi-sample validation of a new instrument to assess mental illness stigma resistance.

PubMed

Firmin, Ruth L; Lysaker, Paul H; McGrew, John H; Minor, Kyle S; Luther, Lauren; Salyers, Michelle P

2017-12-01

Although associated with key recovery outcomes, stigma resistance remains under-studied largely due to limitations of existing measures. This study developed and validated a new measure of stigma resistance. Preliminary items, derived from qualitative interviews of people with lived experience, were pilot tested online with people self-reporting a mental illness diagnosis (n = 489). Best performing items were selected, and the refined measure was administered to an independent sample of people with mental illness at two state mental health consumer recovery conferences (n = 202). Confirmatory factor analyses (CFA) guided by theory were used to test item fit, correlations between the refined stigma resistance measure and theoretically relevant measures were examined for validity, and test-retest correlations of a subsample were examined for stability. CFA demonstrated strong fit for a 5-factor model. The final 20-item measure demonstrated good internal consistency for each of the 5 subscales, adequate test-retest reliability at 3 weeks, and strong construct validity (i.e., positive associations with quality of life, recovery, and self-efficacy, and negative associations with overall symptoms, defeatist beliefs, and self-stigma). The new measure offers a more reliable and nuanced assessment of stigma resistance. It may afford greater personalization of interventions targeting stigma resistance. Copyright © 2017 Elsevier B.V. All rights reserved.

Editorial: Global action to reduce HIV stigma and discrimination.

PubMed

Grossman, Cynthia I; Stangl, Anne L

2013-11-13

There is no question that the stigma and discrimination associated with HIV and AIDS can be reduced through intervention. The inclusion of stigma and discrimination reduction as a critical component of achieving an AIDS-free generation in recent UNAIDS, UN and PEPFAR political initiatives is promising. Yet national governments need evidence on effective interventions at the individual, community and societal levels in order to strategically incorporate stigma and discrimination reduction into national AIDS plans. Currently, the heterogeneity of stigma and discrimination reduction approaches and measurement makes it challenging to compare and contrast evaluated interventions. Moving forward, it is critical for the research community to: (1) clearly link intervention activities to the domains of stigma to be shifted; (2) assess the stigma domains in a consistent manner; and (3) link stigma and discrimination reduction with HIV prevention, care and treatment outcomes (e.g., uptake, adherence and retention of ART). These steps would further advance the scientific evidence base of stigma and discrimination reduction and allow for the identification of effective interventions that could be scaled up by national governments.

Men's and women's experiences with HIV and stigma in Swaziland.

PubMed

Shamos, Sara; Hartwig, Kari A; Zindela, Nomsa

2009-12-01

To explore how gender differentially affects the stigma experiences of people living with HIV (PLHIV) in Swaziland, the extent and dimensions of HIV-related felt and enacted stigma and social support were analyzed. Thirty-seven semistructured, face-to-face interviews were conducted with PLHIV in Swaziland between 2004 and 2006. Through the process of conceptual analysis, themes, including felt stigma, information management, enacted stigma, and social support, were explored, coded, and analyzed in the contexts of partner and familial relationships, and workplace and neighborhood settings. Findings revealed that there were high levels of felt stigma in all contexts, yet fewer than anticipated accounts of enacted stigma in family, work, and neighborhood contexts compared to their expressions of felt stigma. The amount and characteristics of felt and enacted stigma and social support differed based on gender, as women often experienced more felt and enacted stigma than men, and had less definite financial or emotional support.

Predictors of personal, perceived and self-stigma towards anxiety and depression.

PubMed

Busby Grant, J; Bruce, C P; Batterham, P J

2016-06-01

Stigma towards individuals experiencing a mental illness is associated with a range of negative psychological, social and financial outcomes. Factors associated with stigma remain unclear; the relationship between stigma and various personal factors may depend on both the type of disorder being stigmatised and what type of stigma is assessed. Different forms of stigma include personal stigma (negative attitudes towards others), perceived stigma (perceived attitudes of others) and self-stigma (self-attribution of others' negative attitudes). Three hundred and fifty university students and members of the general public completed an online survey assessing contact with and knowledge of both depression and anxiety, age, gender, current depression and anxiety symptoms, and personal, perceived and self-stigma for both depression and anxiety. Greater contact with, and knowledge of that illness predicted lower personal stigma for both anxiety and depression. Participants with greater levels of current depression symptomatology and females, reported higher perceived stigma towards depression. Males reported higher personal stigma for anxiety. For both anxiety and depression, higher current symptomatology was associated with greater levels of self-stigma towards the illness. Findings confirm the role of contact and knowledge in personal stigma for both disorders, consistent with previous findings. This finding also supports evidence that interventions addressing these factors are associated with a decline in personal stigma. However, lack of relationship between contact with, and knowledge of a mental illness and perceived and self-stigma for either depression or anxiety suggests that these factors may not play a major role in perceived or self-stigma. The identification of symptomatology as a key factor associated with self-stigma for both anxiety and depression is significant, and has implications for community-wide interventions aiming to increase help-seeking behaviour

Exploring diabetes type 1-related stigma

PubMed Central

Abdoli, Samereh; Abazari, Parvaneh; Mardanian, Leila

2013-01-01

Background: Empowerment of people with diabetes means integrating diabetes with identity. However, others’ stigmatization can influence it. Although diabetes is so prevalent among Iranians, there is little knowledge about diabetes-related stigma in Iran. The present study explored diabetes-related stigma in people living with type 1 diabetes in Isfahan. Materials and Methods: A conventional content analysis was used with in-depth interview with 26 people with and without diabetes from November 2011 to July 2012. Results: A person with type 1 diabetes was stigmatized as a miserable human (always sick and unable, death reminder, and intolerable burden), rejected marriage candidate (busy spouse, high-risk pregnant), and deprived of a normal life [prisoner of (to must), deprived of pleasure]. Although, young adults with diabetes undergo all aspects of the social diabetes-related stigma; in their opinion they were just deprived of a normal life Conclusion: It seems that in Isfahan, diabetes-related stigma is of great importance. In this way, conducting an appropriate intervention is necessary to improve the empowerment process in people with type 1 diabetes in order to reduce the stigma in the context. PMID:23983731

Self-Stigma and Coming Out about One's Mental Illness

ERIC Educational Resources Information Center

Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rusch, Nicolas

2010-01-01

Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with…

Structural stigma: Research evidence and implications for psychological science.

PubMed

Hatzenbuehler, Mark L

2016-11-01

Psychological research has provided essential insights into how stigma operates to disadvantage those who are targeted by it. At the same time, stigma research has been criticized for being too focused on the perceptions of stigmatized individuals and on microlevel interactions, rather than attending to structural forms of stigma. This article describes the relatively new field of research on structural stigma, which is defined as societal-level conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and well-being of the stigmatized. I review emerging evidence that structural stigma related to mental illness and sexual orientation (a) exerts direct and synergistic effects on stigma processes that have long been the focus of psychological inquiry (e.g., concealment, rejection sensitivity), (b) serves as a contextual moderator of the efficacy of psychological interventions, and (c) contributes to numerous adverse health outcomes for members of stigmatized groups-ranging from dysregulated physiological stress responses to premature mortality-indicating that structural stigma represents an underrecognized mechanism producing health inequalities. Each of these pieces of evidence suggests that structural stigma is relevant to psychology and therefore deserves the attention of psychological scientists interested in understanding and ultimately reducing the negative effects of stigma. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Stigma and psychological distress in suicide survivors.

PubMed

Scocco, Paolo; Preti, Antonio; Totaro, Stefano; Ferrari, Alessandro; Toffol, Elena

2017-03-01

Suicide bereavement is frequently related to clinically significant psychological distress and affected by stigma. This study was designed to evaluate the relationship between psychological distress by psychopathological domains and stigma, in a sample of individuals bereaved by suicide (suicide survivors). The data were collected between January 2012 and December 2014 and included information on sociodemographic variables (gender, age, marital status and education level) and responses to the Stigma of Suicide Survivor scale (STOSSS) and the Brief Symptom Inventory (BSI). One hundred and fifty-five suicide survivors completed the evaluation and were included in the study. Levels of psychological distress in suicide survivors, as measured by BSI, were positively related to levels of perceived stigma toward suicide survivors, as measured by STOSSS. The association was not affected by age and gender, or by marital status, education level, days from suicide or a personal history of suicide attempt. Participants with higher scores on almost all subscales of the BSI, particularly the interpersonal sensitivity and paranoid ideation subscales, reported the highest levels of perceived stigma toward suicide survivors. Levels of distress in subjects bereaved by the suicide of a relative or friend were positively associated with levels of perceived stigma toward suicide survivors. Specific interventions dedicated to the bereavement of suicide survivors might help to alleviate not only psychological distress but also stigma towards loss by suicide. Copyright © 2017 Elsevier Inc. All rights reserved.

[Associations between stigma perception and stigma coping behavior and quality of life in schizophrenic patients treated at a community rehabilitation center].

PubMed

Tseng, Chiu-Jung; Chiou, Jeng-Yuan; Yen, Wen-Jiuan; Su, Hui-Chen; Hsiao, Chiu-Yueh

2012-08-01

Quality of life (QOL) is a critical issue in mental health care. The associations between quality of life and schizophrenia patients' stigma perception and stigma coping behavior are not well understood. This study investigated quality of life in schizophrenia patients. We used a cross-sectional, correlational research design; enrolled 119 individuals diagnosed with schizophrenia as participants; and used instruments including a demographics datasheet, perceived stigma scale, stigma coping behavior scale, and the World Health Organization quality of life scale, brief version to collect data. Data were analyzed using SPSS 12.0 for Windows software. (1) Participants had an average QOL index score of 62.40, indicating moderate quality of life; (2) Long working hours, holding rehabilitation-related employment, and receiving social welfare support correlated with lower QOL; (3) Marital issues had the greatest impact on quality of life, with participants who chose secrecy ÷ concealment reporting generally better QOL; (4) Social welfare support, number of working hours, stigma perception, stigma coping, level of job satisfaction, and level of salary satisfaction together accounted for 48.8% of total QOL variance. Findings increase our understanding of the influence of socio-demographics, stigma perception, and stigma coping behavior on quality of life in individuals with schizophrenia. Greater community involvement in schizophrenia treatment programs can enhance patient satisfaction with their jobs and lives.

Stigma of Mental Illness-2: Non-compliance and Intervention

PubMed Central

Shrivastava, Amresh; Johnston, Megan; Bureau, Yves

2012-01-01

The consequences of stigma are preventable. We argue that individual attention should be provided to patients when dealing with stigma. Also, in order to deal with the impact of stigma on an individual basis, it needs to be assessed during routine clinical examinations, quantified and followed up to observe whether or not treatment can reduce its impact. A patient-centric anti-stigma programme that delivers the above is urgently needed. To this end, this review explores the experiences, treatment barriers and consequences due to stigma. We also offer putative solutions to this problem. PMID:22654384

Adolescent Mental Health Consumers' Self-Stigma: Associations with Parents' and Adolescents' Illness Perceptions and Parental Stigma

ERIC Educational Resources Information Center

Moses, Tally

2010-01-01

Currently, little is known about adolescents' self-stigma experiences as mental health (MH) treatment recipients. Hence, this study addresses the following two questions: (a) what are adolescents' and parents' perceptions of stigma and perceptions of the cause, controllability, and anticipated outcome (illness perceptions) of adolescents' MH…

Stakeholder Perspectives on the Stigma of Suicide Attempt Survivors.

PubMed

Sheehan, Lindsay L; Corrigan, Patrick W; Al-Khouja, Maya A

2017-03-01

Past scholarly efforts to describe and measure the stigma surrounding suicide have largely viewed suicide stigma from the perspective of the general public. In the spirit of community-based participatory research (CBPR), the current study brought together a diverse stakeholder team to qualitatively investigate the suicide stigma as experienced by those most intimately affected by suicide. Seven focus groups (n = 62) were conducted with suicide attempt survivors, family members of those who died by suicide, and suicide loss therapists. Themes were derived for stereotypes (n = 30), prejudice (n = 3), and discrimination (n = 4). People who attempted suicide were seen as attention-seeking, selfish, incompetent, emotionally weak, and immoral. Participants described personal experiences of prejudice and discrimination, including those with health professionals. Participants experienced public stigma, self-stigma, and label avoidance. Analyses reveal that the stigma of suicide shares similarities with stereotypes of mental illness, but also includes some important differences. Attempt survivors may be subject to double stigma, which impedes recovery and access to care.

My secret: the social meaning of HIV/AIDS stigma.

PubMed

Judgeo, N; Moalusi, K P

2014-01-01

This study uses Goffman's [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] theory of stigma as an intellectual scaffold to help understand the social meaning of HIV/AIDS stigma from People Living with HIV/AIDS. The study adopts a qualitative approach because of its appropriateness for unravelling subjective phenomena such as the experiences of HIV/AIDS stigma. In-depth interviews were conducted with 10 HIV-positive employees of a retailing company located in the Western Cape province of South Africa who volunteered to participate in the study. The participants with the discreditable stigma internalised society's prejudice towards those living with the virus. As a result, the participants relied on self-isolation and social withdrawal to cope with enacted stigma. Managing information about one's status and deciding whether, who, when, etc., to tell are crucial questions. The participants feared being devalued by family, friends, co-workers and the community. In concurrence with Goffman [1963], the HIV/AIDS stigma is seen as about relationships.

Addressing Mental Illness Stigma in the Psychology Classroom

ERIC Educational Resources Information Center

Maranzan, K. Amanda

2016-01-01

A number of initiatives are aimed at reducing mental illness stigma, yet stigma remains a problem in the general population. A focus on stigma reduction with students is particularly relevant, as students often hold negative attitudes toward mental illness, have regular contact with persons experiencing mental health difficulties, and because…

Stigma development and receptivity in almond (Prunus dulcis).

PubMed

Yi, Weiguang; Law, S Edward; McCoy, Dennis; Wetzstein, Hazel Y

2006-01-01

Fertilization is essential in almond production, and pollination can be limiting in production areas. This study investigated stigma receptivity under defined developmental stages to clarify the relationship between stigma morphology, pollen germination, tube growth and fruit set. Light and scanning electron microscopy were employed to examine stigma development at seven stages of flower development ranging from buds that were swollen to flowers in which petals were abscising. Flowers at different stages were hand pollinated and pollen germination and tube growth assessed. Artificial pollinations in the field were conducted to determine the effect of flower age on fruit set. Later stages of flower development exhibited greater stigma receptivity, i.e. higher percentages of pollen germination and more extensive tube growth occurred in older (those opened to the flat petal stage or exhibiting petal fall) than younger flowers. Enhanced stigma receptivity was associated with elongation of stigmatic papillae and increased amounts of stigmatic exudate that inundated papillae at later developmental stages. Field pollinations indicated that the stigma was still receptive and nut set was maintained in older flowers. Stigma receptivity in almond does not become optimal until flowers are past the fully open stage. The stigma is still receptive and fruit set is maintained in flowers even at the stage when petals are abscising. Strategies to enhance pollination and crop yield, including the timing and placement of honey bees, should consider the effectiveness of developmentally advanced flowers.

Perception of stigma toward mental illness in South India

PubMed Central

Venkatesh, Bhumika T.; Andrews, Teddy; Mayya, Sreemathi S.; Singh, Mannat M.; Parsekar, Shradha S.

2015-01-01

Background: Stigma associated with mental illnesses is one of the principal causes for mentally ill people not receiving adequate mental health care and treatment. The study was conducted to assess the extent of stigma associated with mental illness and knowledge of mental illness among the community. Materials and Methods: Community-based, cross-sectional study was conducted among 445 respondents from Udupi district; the community attitude toward the mentally ill (CAMI) scale was used to assess stigma. The probability proportional to sampling size technique was adopted to select the wards/blocks. Household from blocks/wards were selected using convenience sampling. Self- administered semi-structured questionnaire was used to collect the information. Data was analyzed using the software SPSS version 15. Results: Of the total 445 respondents, the prevalence of stigma toward mentally ill people was 74.61% (95% confidence interval, 0.7057, 0.7866). The prevalence of stigma was high under all the four domains of CAMI scale. High prevalence of stigma was seen among females and people with higher income. Conclusions: The overall prevalence of stigma toward PWMI was found to be high. The stigma toward PWMI was associated with gender with respect to AU, BE and CMHI. Hence, the study suggests that there is a strong need to eliminate stigma associated with mental illness to improve the mental health status of the region. PMID:26288791

HIV stigma and social capital in women living with HIV

PubMed Central

Cuca, Yvette P.; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

2016-01-01

Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma. PMID:27697368

Understanding the Experience of Stigma for Parents of Children with Autism Spectrum Disorder and the Role Stigma Plays in Families' Lives.

PubMed

Kinnear, Sydney H; Link, Bruce G; Ballan, Michelle S; Fischbach, Ruth L

2016-03-01

Stigma is widely perceived in the lives of families with autism spectrum disorder (ASD) yet large, systematic studies have not been undertaken. Following Link and Phelan's (Ann Rev Sociol 27:363-385, 2001) model, this study of 502 Simons Simplex Collection families details how different factors contribute to stigma and how each appears to increase the overall difficulty of raising a child with ASD. The model begins with the child's behavioral symptoms and then specifies stigma processes of stereotyping, rejection, and exclusion. Autism behaviors contribute both to the difficulty families experience raising a child with autism and to the stigma processes associated with those behaviors. Stigma also plays a significant role (.282, p < .001) in predicting how difficult life is overall for parents.

The experience of SARS-related stigma at Amoy Gardens.

PubMed

Lee, Sing; Chan, Lydia Y Y; Chau, Annie M Y; Kwok, Kathleen P S; Kleinman, Arthur

2005-11-01

Severe Acute Respiratory Syndrome (SARS) possesses characteristics that render it particularly prone to stigmatization. SARS-related stigma, despite its salience for public health and stigma research, has had little examination. This study combines survey and case study methods to examine subjective stigma among residents of Amoy Gardens (AG), the first officially recognized site of community outbreak of SARS in Hong Kong. A total of 903 residents of AG completed a self-report questionnaire derived from two focus groups conducted toward the end of the 3-month outbreak. Case studies of two residents who lived in Block E, the heart of the SARS epidemic at AG, complement the survey data. Findings show that stigma affected most residents and took various forms of being shunned, insulted, marginalized, and rejected in the domains of work, interpersonal relationships, use of services and schooling. Stigma was also associated with psychosomatic distress. Residents' strategies for diminishing stigma varied with gender, age, education, occupation, and proximity to perceived risk factors for SARS such as residential location, previous SARS infection and the presence of ex-SARS household members. Residents attributed stigma to government mismanagement, contagiousness of the mysterious SARS virus, and alarmist media reporting. Stigma clearly decreased, but never completely disappeared, after the outbreak. The findings confirm and add to existing knowledge on the varied origins, correlates, and impacts of stigma. They also highlight the synergistic roles of inconsistent health policy responses and risk miscommunication by the media in rapidly amplifying stigma toward an unfamiliar illness. While recognizing the intrinsically stigmatizing nature of public health measures to control SARS, we recommend that a consistent inter-sectoral approach is needed to minimize stigma and to make an effective health response to future outbreaks.

Weight Stigma Reduction and Genetic Determinism

PubMed Central

Hilbert, Anja

2016-01-01

One major approach to weight stigma reduction consists of decreasing beliefs about the personal controllability of—and responsibility for—obesity by educating about its biogenetic causes. Evidence on the efficacy of this approach is mixed, and it remains unclear whether this would create a deterministic view, potentially leading to detrimental side-effects. Two independent studies from Germany using randomized designs with delayed-intervention control groups served to (1) develop and pilot a brief, interactive stigma reduction intervention to educate N = 128 university students on gene × environment interactions in the etiology of obesity; and to (2) evaluate this intervention in the general population (N = 128) and determine mechanisms of change. The results showed (1) decreased weight stigma and controllability beliefs two weeks post-intervention in a student sample; and (2) decreased internal attributions and increased genetic attributions, knowledge, and deterministic beliefs four weeks post-intervention in a population sample. Lower weight stigma was longitudinally predicted by a decrease in controllability beliefs and an increase in the belief in genetic determinism, especially in women. The results underline the usefulness of a brief, interactive intervention promoting an interactionist view of obesity to reduce weight stigma, at least in the short term, lending support to the mechanisms of change derived from attribution theory. The increase in genetic determinism that occurred despite the intervention’s gene × environment focus had no detrimental side-effect on weight stigma, but instead contributed to its reduction. Further research is warranted on the effects of how biogenetic causal information influences weight management behavior of individuals with obesity. PMID:27631384

Weight Stigma Reduction and Genetic Determinism.

PubMed

Hilbert, Anja

2016-01-01

One major approach to weight stigma reduction consists of decreasing beliefs about the personal controllability of-and responsibility for-obesity by educating about its biogenetic causes. Evidence on the efficacy of this approach is mixed, and it remains unclear whether this would create a deterministic view, potentially leading to detrimental side-effects. Two independent studies from Germany using randomized designs with delayed-intervention control groups served to (1) develop and pilot a brief, interactive stigma reduction intervention to educate N = 128 university students on gene × environment interactions in the etiology of obesity; and to (2) evaluate this intervention in the general population (N = 128) and determine mechanisms of change. The results showed (1) decreased weight stigma and controllability beliefs two weeks post-intervention in a student sample; and (2) decreased internal attributions and increased genetic attributions, knowledge, and deterministic beliefs four weeks post-intervention in a population sample. Lower weight stigma was longitudinally predicted by a decrease in controllability beliefs and an increase in the belief in genetic determinism, especially in women. The results underline the usefulness of a brief, interactive intervention promoting an interactionist view of obesity to reduce weight stigma, at least in the short term, lending support to the mechanisms of change derived from attribution theory. The increase in genetic determinism that occurred despite the intervention's gene × environment focus had no detrimental side-effect on weight stigma, but instead contributed to its reduction. Further research is warranted on the effects of how biogenetic causal information influences weight management behavior of individuals with obesity.

Stroke-Related Stigma among West Africans: Patterns and Predictors

PubMed Central

Sarfo, Fred Stephen; Nichols, Michelle; Qanungo, Suparna; Teklehaimanot, Abeba; Singh, Arti; Mensah, Nathaniel; Saulson, Raelle; Gebregziabher, Mulugeta; Ezinne, Uvere; Owolabi, Mayowa; Jenkins, Carolyn; Ovbiagele, Bruce

2017-01-01

Background Disability-adjusted life-years lost after stroke in Low & Middle-Income Countries (LMICs) is almost seven times those lost in High-income countries. Although individuals living with chronic neurological and mental disorders are prone to stigma, there is a striking paucity of literature on stroke-related stigma particularly from LMICs. Objective To assess the prevalence, severity, determinants and psychosocial consequences of stigma among LMIC stroke survivors. Methods Between November 2015 and February 2016, we conducted a cross-sectional survey of 200 consecutive stroke survivors attending a neurology clinic in a tertiary medical center in Ghana. The validated 8-Item Stigma Scale for Chronic Illness (SSCI-8) questionnaire was administered to study participants to assess internalized and enacted domains of stigma at the personal dimension with further adaptation to capture family and community stigma experienced by stroke participants. Responses on the SSCI-8 were scored from 1–5 for each item, where 1=never, 2=rarely, 3=sometimes, 4=often and 5=always with a score range of 8–40. Demographic and clinical data on stroke type and severity as well as depression and health-related quality of life indicators were also collected. Predictors of stroke-related stigma were assessed using Linear Models (GLM) via Proc GENMOD in SAS 9.4. Results 105 (52.5%) subjects recruited were males and the mean ± SD age of stroke survivors in this survey was 62.0 ± 14.4 years. Mean SSCI-8 score was highest for personal stigma (13.7 ± 5.7), which was significantly higher than family stigma (11.9 ± 4.6; p=0.0005) and social/community stigma (11.4 ± 4.4; p<0.0001). Approximately 80% of the cohort reported experiencing mild-to-moderate degrees of stigma. A graded increase in scores on the Geriatric Depression Scale and Centre for Epidemiological Studies-Depression scale was observed across the three categories. Living in an urban setting was associated with higher SSCI-8

Internalized stigma in psoriasis: A multicenter study.

PubMed

Alpsoy, Erkan; Polat, Mualla; FettahlıoGlu-Karaman, Bilge; Karadag, Ayse Serap; Kartal-Durmazlar, Pelin; YalCın, Basak; Emre, Selma; Didar-Balcı, Didem; Bilgic-Temel, Asli; Arca, Ercan; Koca, Rafet; Gunduz, Kamer; Borlu, Murat; Ergun, Tulin; Dogruk-Kacar, Seval; Cordan-Yazici, Ayca; Dursun, Pınar; BilgiC, Ozlem; Gunes-Bilgili, Serap; Sendur, Neslihan; Baysal, Ozge; Halil-Yavuz, Ibrahim; Yagcioglu, Gizem; Yilmaz, Ertan; Kavuzlu, Ufuk; Senol, Yesim

2017-08-01

Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease. © 2017 Japanese Dermatological Association.

Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes.

PubMed

Turan, Bulent; Hatcher, Abigail M; Weiser, Sheri D; Johnson, Mallory O; Rice, Whitney S; Turan, Janet M

2017-06-01

We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health.

Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes

PubMed Central

Hatcher, Abigail M.; Weiser, Sheri D.; Johnson, Mallory O.; Rice, Whitney S.; Turan, Janet M.

2017-01-01

We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health. PMID:28426316

The Stigma of Hearing Loss

PubMed Central

Wallhagen, Margaret I.

2010-01-01

Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants were naive to or had not worn hearing aids in the past year. Data were analyzed using grounded theory, constant comparative methodology. Results: Perceived stigma emerged as influencing decision-making processes at multiple points along the experiential continuum of hearing loss, such as initial acceptance of hearing loss, whether to be tested, type of hearing aid selected, and when and where hearing aids were worn. Stigma was related to 3 interrelated experiences, alterations in self-perception, ageism, and vanity and was influenced by dyadic relationships and external societal forces, such as health and hearing professionals and media. Implications: Findings are discussed in relation to theoretical perspectives regarding stigma and ageism and suggest the need to destigmatize hearing loss by promoting its assessment and treatment as well as emphasizing the importance of remaining actively engaged to support positive physical and cognitive functioning. PMID:19592638

Involuntary psychiatric hospitalisation, stigma stress and recovery: a 2-year study.

PubMed

Xu, Z; Lay, B; Oexle, N; Drack, T; Bleiker, M; Lengler, S; Blank, C; Müller, M; Mayer, B; Rössler, W; Rüsch, N

2018-01-31

Compulsory admission can be experienced as devaluing and stigmatising by people with mental illness. Emotional reactions to involuntary hospitalisation and stigma-related stress may affect recovery, but longitudinal data are lacking. We, therefore, examined the impact of stigma-related emotional reactions and stigma stress on recovery over a 2-year period. Shame and self-contempt as emotional reactions to involuntary hospitalisation, stigma stress, self-stigma and empowerment, as well as recovery were assessed among 186 individuals with serious mental illness and a history of recent involuntary hospitalisation. More shame, self-contempt and stigma stress at baseline were correlated with increased self-stigma and reduced empowerment after 1 year. More stigma stress at baseline was associated with poor recovery after 2 years. In a longitudinal path analysis more stigma stress at baseline predicted poorer recovery after 2 years, mediated by decreased empowerment after 1 year, controlling for age, gender, symptoms and recovery at baseline. Stigma stress may have a lasting detrimental effect on recovery among people with mental illness and a history of involuntary hospitalisation. Anti-stigma interventions that reduce stigma stress and programs that enhance empowerment could improve recovery. Future research should test the effect of such interventions on recovery.

Measuring HIV-related stigma among healthcare providers: a systematic review.

PubMed

Alexandra Marshall, S; Brewington, Krista M; Kathryn Allison, M; Haynes, Tiffany F; Zaller, Nickolas D

2017-11-01

In the United States, HIV-related stigma in the healthcare setting is known to affect the utilization of prevention and treatment services. Multiple HIV/AIDS stigma scales have been developed to assess the attitudes and behaviors of the general population in the U.S. towards people living with HIV/AIDS, but fewer scales have been developed to assess HIV-related stigma among healthcare providers. This systematic review aimed to identify and evaluate the measurement tools used to assess HIV stigma among healthcare providers in the U.S. The five studies selected quantitatively assessed the perceived HIV stigma among healthcare providers from the patient or provider perspective, included HIV stigma as a primary outcome, and were conducted in the U.S. These five studies used adapted forms of four HIV stigma scales. No standardized measure was identified. Assessment of HIV stigma among providers is valuable to better understand how this phenomenon may impact health outcomes and to inform interventions aiming to improve healthcare delivery and utilization.

Assessing the Impact of Food Assistance on Stigma Among People Living with HIV in Uganda Using the HIV/AIDS Stigma Instrument-PLWA (HASI-P).

PubMed

Maluccio, John A; Wu, Fan; Rokon, Redwan B; Rawat, Rahul; Kadiyala, Suneetha

2017-03-01

HIV-related stigma among persons living with HIV/AIDS (PLHIV) is prevalent throughout sub-Saharan Africa. There is limited evidence, however, on which interventions are effective in reducing it. We used data from a prospective impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Uganda to examine the program impact on stigma. Stigma was measured using the comprehensive HASI-P scale, which demonstrated good internal consistency (Cronbach's alpha = 0.87) and was correlated with several related constructs including physical and mental health-related quality of life, disclosure, and physical health symptoms in the sample. Using quasi-experimental difference-in-difference matching methods to better infer causality, we tested whether the intervention improved the overall stigma scale and its subscales. The food assistance intervention had a significant effect on reported internalized (but not external) stigma of approximately 0.2 SD (p < 0.01). The HASI-P stigma scale is a useful tool for measuring and tracking stigma. Food assistance interventions, embedded in an HIV care program, can reduce internalized stigma.

Psychometric Properties of the Dutch Depression Stigma Scale (DSS) and Associations with Personal and Perceived Stigma in a Depressed and Community Sample

PubMed Central

Cuijpers, P.; Griffiths, K. M.; Kleiboer, A. M.

2016-01-01

Background Research on depression stigma is needed to gain more insight into the underlying construct and to reduce the level of stigma in the community. However, few validated measurements of depression stigma are available in the Netherlands. Therefore, this study first sought to examine the psychometric properties of the Dutch translation of the Depression Stigma Scale (DSS). Second, we examined which demographic (gender, age, education, partner status) and other variables (anxiety and knowledge of depression) are associated with personal and perceived stigma within these samples. Methods The study population consisted of an adult convenience sample (n = 253) (study 1) and a community adult sample with elevated depressive symptoms (n = 264) (study 2). Factor structure, internal consistency, and validity were assessed. The associations between stigma, demographic variables and anxiety level were examined with regression analyses. Results Confirmatory factor analysis supported the validity and internal consistency of the DSS personal stigma scale. Internal consistency was sufficient (Cronbach’s alpha = .70 (study 1) and .77 (study 2)). The results regarding the perceived stigma scale revealed no clear factor structure. Regression analyses showed that personal stigma was higher in younger people, those with no experience with depression, and those with lower education. Conclusions This study established the validity and internal consistency of the DSS personal scale in the Netherlands, in a community sample and in people with elevated depressive symptoms. However, additional research is needed to examine the factor structure of the DSS perceived scale and its use in other samples. PMID:27500969

Obesity Stigma: Important Considerations for Public Health

PubMed Central

Heuer, Chelsea A.

2010-01-01

Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health. PMID:20075322

Safety Evaluation of Crocin (a constituent of saffron) Tablets in Healthy Volunteers

PubMed Central

Mohamadpour, Amir Houshang; Ayati, Zahara; Parizadeh, Mohammad–Reza; Rajbai, Omid; Hosseinzadeh, Hossein

2013-01-01

Objective(s): Crocin is the chemical ingredient primarily responsible for the color of saffron. It has different pharmacological effects such as antioxidant, anticancer and memory improving activities. Crocin tablets were evaluated for short-term safety and tolerability in healthy adult volunteers. Materials and Methods: The study was a randomized, double-blind, placebo-controlled design consisting of one month treatment of crocin tablets. Volunteers who fulfilled inclusion and exclusion criteria were randomized into 2 groups of 22 each (males and females) and received 20 mg crocin tablets or placebo. General measures of health were recorded during the study such as hematological, biochemical, hormonal and urinary parameters in pre and post-treatment periods. Results: No major adverse events were reported during the trial. Crocin tablets did not change the above parameters except that it decreased amylase, mixed white blood cells and PTT in healthy volunteers after one month. Conclusion: This clinical safety evaluation showed a relatively safe and normal profile for crocin in healthy volunteers at the given doses within the trial period. PMID:23638291

The Bad Mother: Stigma, Abortion and Surrogacy.

PubMed

Abrams, Paula

2015-01-01

Stigma taints individuals with a spoiled identity and loss of status or discrimination. This article is the first to examine the stigma attached to abortion and surrogacy and consider how law may stigmatize women for failing to conform to social expectations about maternal roles. Courts should consider evidence of stigma when evaluating laws regulating abortion or surrogacy to determine whether these laws are based on impermissible gender stereotyping. © 2015 American Society of Law, Medicine & Ethics, Inc.

Pride and prejudice--identity and stigma in leprosy work.

PubMed

Harris, Kristine

2011-06-01

This article sets out to expand the way stigma, and those affected by it, are understood within leprosy discourse and to apply these insights to the analysis of the experiences of leprosy workers. The term stigma is often used simply as shorthand for 'negative social experience'. However, to reduce the negative aspects of complex everyday life experiences to a single word is often overly simplistic and can serve to objectify, rather than illuminate, the experiences of those affected. This article argues that in order to understand the lived experience of stigma we must come to understand stigma as an ongoing, dialectical social process and develop an approach to stigma that analytically separates stigma from its negative social consequences. The article applies these insights to data collected during 14 months of fieldwork with front-line leprosy workers in India, which suggests that falling leprosy prevalence rates and a rapidly changing policy landscape have led to leprosy workers feeling marginalised and stigmatised within their own organisation. The article argues that, rather than seeing stigma merely as a negative process in which leprosy workers are passive victims, we must recognise that stigma also plays a key role in the creation and maintenance of leprosy workers' identity and is utilised as a strategic tool in the struggle for influence between different groups within the organisation. Finally, the article argues for the benefit of expanding our understanding of stigma across public health and of applying these insights to designing future interventions.

Self-stigma, self-esteem and age in persons with schizophrenia.

PubMed

Werner, Perla; Aviv, Alex; Barak, Yoram

2008-02-01

The relationship between self-stigma and self-esteem in patients with schizophrenia is receiving increased attention. However, studies to date have been limited to samples of persons under the age of 65. To examine the relationship between self-stigma and self-esteem in people with schizophrenia in both younger and older age groups. Face-to-face interviews were completed with 86 inpatients with schizophrenia in a psychiatric hospital (mean age = 54, 55% female). Self-esteem was assessed using Rosenberg's Self Esteem Scale. Self-stigma was assessed using an adapted version of the Internalized Stigma of Mental Health (ISMI) scale. Information regarding socio-demographic characteristics and psychiatric history and symptomatology was collected. Self-stigma was moderate with only 20-33% of the participants reporting high levels of stigmatization. Older participants reported lower levels of self-stigma than younger participants. A relatively strong association between self-stigma and self-esteem was found. The findings point to the complexity of the association between self-stigma, self-esteem and age in people with schizophrenia. This study stresses the importance of clinicians taking the issue of self-stigma into consideration when treating young and old patients with schizophrenia.

HIV-related stigma experiences: Understanding gender disparities in Thailand.

PubMed

Pannetier, Julie; Lelièvre, Eva; Le Cœur, Sophie

2016-01-01

This paper assesses the relationship between gender and HIV-related stigma experiences among people living with HIV (PLHIV) - enacted and anticipated stigma - and PLHIV caregivers - courtesy stigma - in Northern Thailand, along with the underlying reasons for stigmatising attitudes towards PLHIV - instrumental and symbolic stigma - expressed in the general population. We used data from the Living With Antiretrovirals (LIWA) study conducted on all PLHIV receiving antiretroviral treatment in four district hospitals in Northern Thailand (n = 513) and on a community sample of adults from the general population (n = 500). Women living with HIV and female caregivers of PLHIV reported higher rates of HIV-related stigma experiences than men. Gender interacted with other predictors - the period of HIV diagnosis and age - to increase the level of stigma experienced. Among the general population, attitudes of contact avoidance were infrequent. However, stereotypes depicting PLHIV as blameworthy were highly pervasive, with women perceived as the "victims" of their spouse's irresponsible sexual behaviours. In this context, women were yet more often subjected to HIV-related stigma than men, in particular women diagnosed in the pre-antiretroviral therapy era and younger female caregivers. The role of gender in shaping disparities in HIV-related stigma experiences is discussed.

The multidimensional nature of HIV stigma: evidence from Mozambique.

PubMed

Carrasco, Maria A; Arias, Rosario; Figueroa, Maria E

2017-03-01

HIV stigma continues to be a major challenge to addressing HIV/AIDS in various countries in sub-Saharan Africa, including Mozambique. This paper explores the multidimensional nature of HIV stigma through the thematic analysis of five qualitative studies conducted in high HIV prevalence provinces in Mozambique between 2009 and 2012. These studies included 23 interviews with people living with HIV (PLHIV) (10 women and 13 men); 6 focus groups with 32 peer educators (24 women and 8 men) working for community-based organisations (CBOs) providing services to PLHIV; 17 focus groups with community members (72 men and 70 women); 6 interviews (4 women and 2 men) with people who had family members living with HIV/AIDS; 24 focus groups (12 with men and 12 with women) and 6 interviews with couples. Our findings indicate that HIV stigma is a barrier to HIV testing and counselling, status disclosure, partner notification, and antiretroviral therapy (ART) access and adherence, and that moral stigma seems to be more common than physical stigma. Additionally, the findings highlight that HIV stigma is a dynamic social process that is conceptualised as being tied to personal responsibility. To effectively diminish HIV stigma in Mozambique, future interventions should address moral stigma and re-conceptualise HIV as a chronic disease.

Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us.

PubMed

Griffith, James L; Kohrt, Brandon A

2016-04-01

Psychiatric education is confronted with three barriers to managing stigma associated with mental health treatment. First, there are limited evidence-based practices for stigma reduction, and interventions to deal with stigma against mental health care providers are especially lacking. Second, there is a scarcity of training models for mental health professionals on how to reduce stigma in clinical services. Third, there is a lack of conceptual models for neuroscience approaches to stigma reduction, which are a requirement for high-tier competency in the ACGME Milestones for Psychiatry. The George Washington University (GWU) psychiatry residency program has developed an eight-week course on managing stigma that is based on social psychology and social neuroscience research. The course draws upon social neuroscience research demonstrating that stigma is a normal function of normal brains resulting from evolutionary processes in human group behavior. Based on these processes, stigma can be categorized according to different threats that include peril stigma, disruption stigma, empathy fatigue, moral stigma, and courtesy stigma. Grounded in social neuroscience mechanisms, residents are taught to develop interventions to manage stigma. Case examples illustrate application to common clinical challenges: (1) helping patients anticipate and manage stigma encountered in the family, community, or workplace; (2) ameliorating internalized stigma among patients; (3) conducting effective treatment from a stigmatized position due to prejudice from medical colleagues or patients' family members; and (4) facilitating patient treatment plans when stigma precludes engagement with mental health professionals. This curriculum addresses the need for educating trainees to manage stigma in clinical settings. Future studies are needed to evaluate changes in clinical practices and patient outcomes as a result of social neuroscience-based training on managing stigma.

Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us

PubMed Central

Griffith, James L.; Kohrt, Brandon A.

2016-01-01

Psychiatric education is confronted with three barriers to managing stigma associated with mental health treatment. First, there are limited evidence-based practices for stigma reduction, and interventions to deal with stigma against mental health care providers are especially lacking. Second, there is a scarcity of training models for mental health professionals on how to reduce stigma in clinical services. Third, there is a lack of conceptual models for neuroscience approaches to stigma reduction, which are a requirement for high-tier competency in the ACGME Milestones for Psychiatry. The George Washington University (GWU) psychiatry residency program has developed an eight-week course on managing stigma that is based on social psychology and social neuroscience research. The course draws upon social neuroscience research demonstrating that stigma is a normal function of normal brains resulting from evolutionary processes in human group behavior. Based on these processes, stigma can be categorized according to different threats that include peril stigma, disruption stigma, empathy fatigue, moral stigma, and courtesy stigma. Grounded in social neuroscience mechanisms, residents are taught to develop interventions to manage stigma. Case examples illustrate application to common clinical challenges: (1) helping patients anticipate and manage stigma encountered in the family, community, or workplace; (2) ameliorating internalized stigma among patients; (3) conducting effective treatment from a stigmatized position due to prejudice from medical colleagues or patients’ family members; and (4) facilitating patient treatment plans when stigma precludes engagement with mental health professionals. This curriculum addresses the need for educating trainees to manage stigma in clinical settings. Future studies are needed to evaluate changes in clinical practices and patient outcomes as a result of social neuroscience-based training on managing stigma. PMID:26162463

Self-Stigma in People With Mental Illness

PubMed Central

Watson, Amy C.; Corrigan, Patrick; Larson, Jonathon E.; Sells, Molly

2007-01-01

Persons with mental illnesses such as schizophrenia may internalize mental illness stigma and experience diminished self-esteem and self-efficacy. In this article, we describe a model of self-stigma and examine a hierarchy of mediational processes within the model. Seventy-one individuals with serious mental illness were recruited from a community support program at an outpatient psychiatry department of a community hospital. All participants completed the Self-Stigma of Mental Illness Scale along with measures of group identification (GI), perceived legitimacy (PL), self-esteem, and self-efficacy. Models examining the steps involved in self-stigma process were tested. Specifically, after conducting preliminary bivariate analyses, we examine stereotype agreement as a mediator of GI and PL on stigma self-concurrence (SSC); SSC as a mediator of GI and PL on self-efficacy; and SSC as a mediator of GI and PL on self-esteem. Findings provide partial support for the proposed mediational processes and point to GI, PL, and stereotype agreement as areas to be considered for intervention. PMID:17255118

Stigma towards Marijuana Users and Heroin Users.

PubMed

Brown, Seth A

2015-01-01

Despite high levels of stigmatizing attitudes and behaviors toward individuals with substance use problems, there is surprisingly limited research on understanding the contributors to such high levels. College students with no history of marijuana or heroin use (N=250) completed self-report measures to examine the level of substance use stigma towards individuals using two illicit substances (marijuana and heroin) and the contribution of three perceiver characteristics (sex, previous contact with substance users, and five beliefs about substance use) to three dimensions of stigma (social distance, negative emotions, and forcing treatment). Greater levels of internalized stigma were noted towards individuals who use heroin (versus marijuana). For marijuana use, those who had less previous contact and higher endorsement of certain beliefs (rarity, severity, and less controllability) were associated with greater stigmatizing attitudes. For heroin use, the associations were weak or non-existent. The findings strengthen the argument that substance use stigma needs to be examined and perhaps addressed substance by substance, rather than as a group. Further, contact interventions may be a particularly effective strategy for altering substance use stigma.

Important to investigate the dynamics of the stigma process.

PubMed

Angermeyer, Matthias

2004-01-01

Studies have shown that the stigma of the most common mental disorder, namely depression, expose people with these disorders to a substantial amount of stigmatization in the workplace. Apart from the descriptive assessment of the magnitude of stigma, it is also important to investigate the dynamics of the stigma process. Agreeing with Dr. Stuart, three approaches to research on stigma and the workplace are proposed. The first is the dimension of social stigma, i.e., knowledge, attitudes and practices of employers. The second is the perspectives of the patients, i.e., self- stigmatization. The third is legal and policy frameworks, i.e., structural discrimination.

Self Stigma in People with Intellectual Disabilities and Courtesy Stigma in Family Carers: A Systematic Review

ERIC Educational Resources Information Center

Ali, Afia; Hassiotis, Angela; Strydom, Andre; King, Michael

2012-01-01

People with intellectual disability are one of the most stigmatised groups in society. Despite this, research in this area has been limited. This paper provides a review of studies examining self stigma in people with intellectual disability, and courtesy and affiliate stigma in family carers. An electronic search of studies published between 1990…

Socio-demographic and AIDS-related factors associated with tuberculosis stigma in southern Thailand: a quantitative, cross-sectional study of stigma among patients with TB and healthy community members

PubMed Central

2011-01-01

Background Tuberculosis (TB) remains one of the most important infectious diseases worldwide. A comprehensive approach towards disease control that addresses social factors including stigma is now advocated. Patients with TB report fears of isolation and rejection that may lead to delays in seeking care and could affect treatment adherence. Qualitative studies have identified socio-demographic, TB knowledge, and clinical determinants of TB stigma, but only one prior study has quantified these associations using formally developed and validated stigma scales. The purpose of this study was to measure TB stigma and identify factors associated with TB stigma among patients and healthy community members. Methods A cross-sectional study was performed in southern Thailand among two different groups of participants: 480 patients with TB and 300 healthy community members. Data were collected on socio-demographic characteristics, TB knowledge, and clinical factors. Scales measuring perceived TB stigma, experienced/felt TB stigma, and perceived AIDS stigma were administered to patients with TB. Community members responded to a community TB stigma and community AIDS stigma scale, which contained the same items as the perceived stigma scales given to patients. Stigma scores could range from zero to 30, 33, or 36 depending on the scale. Three separate multivariable linear regressions were performed among patients with TB (perceived and experience/felt stigma) and community members (community stigma) to determine which factors were associated with higher mean TB stigma scores. Results Only low level of education, belief that TB increases the chance of getting AIDS, and AIDS stigma were associated with higher TB stigma scores in all three analyses. Co-infection with HIV was associated with higher TB stigma among patients. All differences in mean stigma scores between index and referent levels of each factor were less than two points, except for incorrectly believing that TB

More than Skin Deep: Perceptions of, and Stigma against, Tattoos

ERIC Educational Resources Information Center

Martin, Benjamin A.; Dula, Chris S.

2010-01-01

Previous research indicates stigmas can produce feelings of fear, isolation, and discrimination, and that negative stigma has been and still is, associated with tattooing. Due to the rise in tattoo popularity, a method to analyze stigma against tattooed individuals is needed. The Martin Stigma Against Tattoos Survey (MSATS), was created, taken by…

RNA Silencing of Exocyst Genes in the Stigma Impairs the Acceptance of Compatible Pollen in Arabidopsis1[OPEN

PubMed Central

Safavian, Darya; Indriolo, Emily; Chapman, Laura; Ahmed, Abdalla

2015-01-01

Initial pollen-pistil interactions in the Brassicaceae are regulated by rapid communication between pollen grains and stigmatic papillae and are fundamentally important, as they are the first step toward successful fertilization. The goal of this study was to examine the requirement of exocyst subunits, which function in docking secretory vesicles to sites of polarized secretion, in the context of pollen-pistil interactions. One of the exocyst subunit genes, EXO70A1, was previously identified as an essential factor in the stigma for the acceptance of compatible pollen in Arabidopsis (Arabidopsis thaliana) and Brassica napus. We hypothesized that EXO70A1, along with other exocyst subunits, functions in the Brassicaceae dry stigma to deliver cargo-bearing secretory vesicles to the stigmatic papillar plasma membrane, under the pollen attachment site, for pollen hydration and pollen tube entry. Here, we investigated the functions of exocyst complex genes encoding the remaining seven subunits, SECRETORY3 (SEC3), SEC5, SEC6, SEC8, SEC10, SEC15, and EXO84, in Arabidopsis stigmas following compatible pollinations. Stigma-specific RNA-silencing constructs were used to suppress the expression of each exocyst subunit individually. The early postpollination stages of pollen grain adhesion, pollen hydration, pollen tube penetration, seed set, and overall fertility were analyzed in the transgenic lines to evaluate the requirement of each exocyst subunit. Our findings provide comprehensive evidence that all eight exocyst subunits are necessary in the stigma for the acceptance of compatible pollen. Thus, this work implicates a fully functional exocyst complex as a component of the compatible pollen response pathway to promote pollen acceptance. PMID:26443677

SELF-STIGMA AND COMING OUT ABOUT ONE’S MENTAL ILLNESS

PubMed Central

Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rüsch, Nicolas

2013-01-01

Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person’s quality of life are discussed. PMID:23970807

HIV Stigma and Social Capital in Women Living With HIV.

PubMed

Cuca, Yvette P; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Tuberculosis stigma in Gezira State, Sudan: a case-control study.

PubMed

Ahmed Suleiman, M M; Sahal, N; Sodemann, M; El Sony, A; Aro, A R

2013-03-01

To evaluate the prevalence of tuberculosis (TB) stigma and to determine the relation between socio-demographic characteristics and TB stigma among TB cases and their controls in Gezira State, Sudan. A case-control study design was used. New smear-positive TB patients registered in Gezira State in 2010 (n = 425) and controls who attended the same health facility for other reasons (n < 850) formed the study population. Stigma was measured using a standard modified World Health Organization TB KAP (knowledge, attitudes, practice) instrument. TB stigma did not differ between TB cases and controls; mild stigma was found in both groups. The higher degree of stigma among both groups was significantly associated with higher age, lower level of education, residence in rural areas, unemployment and poor TB awareness, while sex had no association with the degree of stigma in either group. Although TB stigma among the Gezira population was found to be mild, it can affect treatment adherence. Empowering both TB patients and communities by increasing their knowledge through proper education programmes could effectively contribute to the effort of controlling TB in the state.

Gendered aspects of perceived and internalized HIV-related stigma in China

PubMed Central

Li, Li; Lin, Chunqing; Ji, Guoping

2016-01-01

Although studies have demonstrated that females experience more HIV-related stigma than males do, questions remain regarding the different dimensions of the stigma (i.e., perceived vs. internalized stigma) in China. The present study investigated gender differences in HIV-related perceived and internalized stigma, taking into account the potential influence of education. The study was conducted between October 2011 and March 2013. A total of 522 people living with HIV (PLH) were recruited from Anhui Province, China. The PLH participated in a survey using the Computer Assisted Personal Interview (CAPI) method. The gender differences in perceived and internalized HIV-related stigma were calculated with and without stratifying by education level. Female participants had significantly less education than the male participants. No significant difference was observed between females and males with respect to perceived stigma. However, females reported significantly higher internalized stigma than males did (p < .001). When socio-demographic characteristics were controlled, the gender difference in internalized stigma remained significant among educated participants (p = .038). The findings suggested that gender differences in HIV-related stigma were primarily found for internalized stigma. Heightened intervention efforts are encouraged to reduce HIV-related internalized stigma, particularly among female PLH in China and other regions with similar gender dynamics. PMID:27629916

Self-stigma, perceived discrimination and empowerment among people with a mental illness in six countries: Pan European stigma study.

PubMed

Krajewski, Christin; Burazeri, Genc; Brand, Helmut

2013-12-30

A cross-sectional study including 796 individuals with a psychiatric disorder was conducted in Croatia, Israel, Lithuania, Malta, Romania and Sweden in 2010 aiming to assess correlates of self-stigma. The Internalized Stigma of Mental Illness (ISMI) was used to measure self-stigma, whereas the Boston University Empowerment Scale was used to measure the self-efficacy/self-esteem (SESE) and sense of power/powerlessness (PP). Perceived discrimination and devaluation was measured with the Perceived Devaluation and Discrimination (PDD) Scale. Thirty three percent of participants had moderate-to-high ISMI scores. In multivariable-adjusted analysis, significant 'predictors' of high ISMI scores were: age-group of 50-59 years, current employment, lower social contacts, and minimal-to-low SESE and PP scores. Remarkably, no significant association between ISMI and PDD was evident. Furthermore, there was evidence of a significant interaction between SESE and country. Study participants might not be representative to all individuals with mental disorders in countries included in this survey. Our findings indicate that people with psychiatric diseases suffer both self-stigma and perceived discrimination and devaluation. This is one of the very few reports highlighting country differences and diagnosis disparities of self-stigma among individuals with mental illnesses. Between-country differences should be considered and carefully addressed in the process of policy formulation and interventional programs against stigma. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Signs of stigma and poor mental health among carriers of MRSA.

PubMed

Rump, B; De Boer, M; Reis, R; Wassenberg, M; Van Steenbergen, J

2017-03-01

Many countries have implemented guidelines to prevent transmission of meticillin-resistant Staphylococcus aureus (MRSA). Important contextual factors of stigma can be identified in the context of MRSA. Over the past decade, concerns have been raised over a possible stigmatizing effect of these actions. To identify and quantify the occurrence of MRSA-associated stigma, and to explore its association with mental health in a country with an MRSA 'search and destroy' policy. In 2014, a questionnaire study among 57 Dutch MRSA carriers (people that carry MRSA without signs of MRSA infection) was performed. Stigma was measured with an adjusted version of the Berger HIV Stigma Scale. Mental health was measured with the five-item RAND Mental Health Inquiry. Thirty-two (56%) MRSA carriers reported stigma; of these, eight (14%) reported 'clear stigma' (Berger score >110) and 24 (42%) reported 'suggestive for stigma' (Berger score 76-110). Educational level, female sex and intensive MRSA eradication therapy were associated with higher stigma scores. Poor mental health (RAND score <60) was reported by 33% of MRSA carriers. Stigma and mental health scores were inversely correlated. Stigma was experienced most frequently in healthcare settings, and was seldom experienced in the religious community or at sport facilities. A substantial proportion of MRSA carriers reported stigma due to MRSA, and stigma was associated with poor mental health. Anticipation of MRSA-associated stigma is warranted, both in the way that care is delivered by hospital staff and in the way that care is organized within the hospital. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Occupational Stigma Communication: The Anticipatory Socialization of Sex Educators.

PubMed

Selzer King, Abigail; Jensen, Robin E; Jones, Christina; McCarthy, Michael J

2017-08-21

Controversies about sex education have complex, yet often overlooked, occupational implications related to stigma for teachers. In this study, we interviewed 26 future sex educators in their last year of certification about how their anticipatory socialization experiences spoke to the management of potential occupational stigma. Our analysis revealed two stigma management communication (SMC) strategies future sex educators learned, strategies we term cooperation and opportunism, and identified the ways in which those strategies were responses to stigma content cues of responsibility and peril, respectively. We contend that the interactivity of stigma communication is an important site for the theorizing of as-yet-unidentified SMC strategies, strategies that can be enlisted in a diversity of health education and healthcare contexts.

Dyad conversations about self-stigma in two Scottish communities.

PubMed

Mackay, Rob; Bradstreet, Simon; McArthur, Andy; Dunion, Linda

2015-06-01

This study explored self-stigma in 2 Scottish communities and strategies for challenging stigma and discrimination. A mixed-methods approach was used encompassing a survey including the Internalized Stigma of Mental Illness Inventory (ISMI) and facilitated dyad conversations with people with lived experience of mental illness. Self-reported experience of self-stigma across 2 communities was most closely associated with the ISMI Alienation cluster, accompanied by a high level of agreement with the Stigma Resistance cluster. Some 44% agreed that stereotypes about people with mental health problems applied to them, and almost 2/3 felt that having a mental health problem had spoiled their lives. Many participants reported reduced confidence, loss of hope, a sense of failure, and protecting oneself through social withdrawal. The findings also offer hope through narratives from people who have "pushed back" and are striving to reduce their own self-stigma by engaging with others and managing their own recovery journey. The journey through self-stigma and beyond has to be informed by what we know works with recovery from a mental health problem. At a policy and practice level, we recommend emphasis on 4 priorities: (a) refocusing antistigma and discrimination efforts more on the experiences of people who report stigma, (b) rights-based approaches, (c) identity-based work, and (d) information sharing and educational strategies. (c) 2015 APA, all rights reserved).

Coming out as Fat: Rethinking Stigma

ERIC Educational Resources Information Center

Saguy, Abigail C.; Ward, Anna

2011-01-01

This paper examines the surprising case of women who "come out as fat" to test and refine theories about social change, social mobilization, stigma, and stigma resistance. First, supporting theories about "social movement spillover," we find that overlapping memberships in queer and fat activist groups, as well as networks between these groups,…

Media depictions of health topics: challenge and stigma formats.

PubMed

Smith, Rachel

2007-01-01

This article explored the notion that media depictions of health concerns come in one of two formats: challenge and stigma. After explicating the five features that should appear in challenge format and the seven features of stigma formats, we analyzed the content of health messages in magazines, brochures, and posters (n = 75) in a metropolitan area. The results of a two-factor confirmatory factor model showed that the five suggested features for challenge formats did, indeed, appear together (alpha = .76), and the seven features for stigma formats, also, appeared together (alpha = .90), and showed no residual relationship. In other words, the results suggest that media depictions of health topics appear in either challenge or stigma formats (r = - .87). Health issues appearing in magazine advertisements and articles presented messages in challenge formats, while brochures and posters from largely nonprofit and government groups depicted health issues in stigma formats. Some health topics appeared most often in challenge formats (including cancer, heart disease, and scoliosis), while others appeared in stigma formats (including tuberculosis, hepatitis, smoking, and sexually transmitted diseases [STDs]). Findings suggest that media depictions of health differ, and the implications of stigma and challenge formats are discussed.

Unpacking the public stigma of problem gambling: The process of stigma creation and predictors of social distancing.

PubMed

Hing, Nerilee; Russell, Alex M T; Gainsbury, Sally M

2016-09-01

Background and aims Public stigma diminishes the health of stigmatized populations, so it is critical to understand how and why stigma occurs to inform stigma reduction measures. This study aimed to examine stigmatizing attitudes held toward people experiencing problem gambling, to examine whether specific elements co-occur to create this public stigma, and to model explanatory variables of this public stigma. Methods An online panel of adults from Victoria, Australia (N = 2,000) was surveyed. Measures were based on a vignette for problem gambling and included demographics, gambling behavior, perceived dimensions of problem gambling, stereotyping, social distancing, emotional reactions, and perceived devaluation and discrimination. A hierarchical linear regression was conducted. Results People with gambling problems attracted substantial negative stereotypes, social distancing, emotional reactions, and status loss/discrimination. These elements were associated with desired social distance, as was perceived that problem gambling is caused by bad character, and is perilous, non-recoverable, and disruptive. Level of contact with problem gambling, gambling involvement, and some demographic variables was significantly associated with social distance, but they explained little additional variance. Discussion and conclusions This study contributes to the understanding of how and why people experiencing gambling problems are stigmatized. Results suggest the need to increase public contact with such people, avoid perpetuation of stereotypes in media and public health communications, and reduce devaluing and discriminating attitudes and behaviors.

Unpacking the public stigma of problem gambling: The process of stigma creation and predictors of social distancing

PubMed Central

Hing, Nerilee; Russell, Alex M. T.; Gainsbury, Sally M.

2016-01-01

Background and aims Public stigma diminishes the health of stigmatized populations, so it is critical to understand how and why stigma occurs to inform stigma reduction measures. This study aimed to examine stigmatizing attitudes held toward people experiencing problem gambling, to examine whether specific elements co-occur to create this public stigma, and to model explanatory variables of this public stigma. Methods An online panel of adults from Victoria, Australia (N = 2,000) was surveyed. Measures were based on a vignette for problem gambling and included demographics, gambling behavior, perceived dimensions of problem gambling, stereotyping, social distancing, emotional reactions, and perceived devaluation and discrimination. A hierarchical linear regression was conducted. Results People with gambling problems attracted substantial negative stereotypes, social distancing, emotional reactions, and status loss/discrimination. These elements were associated with desired social distance, as was perceived that problem gambling is caused by bad character, and is perilous, non-recoverable, and disruptive. Level of contact with problem gambling, gambling involvement, and some demographic variables was significantly associated with social distance, but they explained little additional variance. Discussion and conclusions This study contributes to the understanding of how and why people experiencing gambling problems are stigmatized. Results suggest the need to increase public contact with such people, avoid perpetuation of stereotypes in media and public health communications, and reduce devaluing and discriminating attitudes and behaviors. PMID:27513611

Affiliate stigma and caregiver burden in intractable epilepsy.

PubMed

Hansen, Barbara; Szaflarski, Magdalena; Bebin, E Martina; Szaflarski, Jerzy P

2018-06-07

Intractable epilepsy can be challenging for patients and for their families. Disability rates in patients are high, causing tremendous physical and emotional burden on family caregivers. Additionally, caregivers may experience affiliate stigma, where they perceive and internalize the negative societal views of a condition and exhibit a psychological response. Affiliate stigma has been rarely studied in caregivers of those with intractable epilepsy. This study examined the relationship between affiliate stigma and the levels of burden experienced by caregivers, as well as how these levels may vary between those caring for children and adults. This cross-sectional approach used a self-administered survey offered to caregivers of family members with confirmed diagnoses of intractable epilepsy. We measured burden with the 30-item Carer's Assessment of Difficulties Index (CADI) and affiliate stigma with a six-item scale examining caregivers' perceptions of stigma directed toward themselves and their family members with epilepsy. Four nested ordinary-least-squares regression models were estimated using stigma scale scores to predict levels of perceived burden adjusting for demographic variables. Age of the patient with epilepsy was dichotomized (pediatric/adult) to assess a possible moderating effect of patient's age on the relationship between stigma and caregiver burden. Respondents (N = 136) were predominantly White (83%), female (75%), and married (69%), with an average age of 43 years. Patients with epilepsy were 52% male with ages ranging from 2 to 82 years. Each of the regression models yielded positive associations (p < 0.001) between perceived levels of caregiver burden and affiliate stigma. Additionally, the age of the family member with epilepsy moderated (p < 0.05) the effect, with the relationship stronger for caregivers of adults. In a highly select group of patients with refractory epilepsy recruited mostly from a cannabidiol (CBD) clinic

Stigma, sex work, and substance use: a comparative analysis.

PubMed

Benoit, Cecilia; McCarthy, Bill; Jansson, Mikael

2015-03-01

Stigma is a widely used concept in social science research and an extensive literature claims that stigmatisation contributes to numerous negative health outcomes. However, few studies compare groups that vary in the extent to which they are stigmatised and even fewer studies examine stigma's independent and mediating effects. This article addresses these gaps in a comparative study of perceived stigma and drug use among three low-income feminised service occupations: sex work, food and alcoholic beverage serving, and barbering and hairstyling. An analysis of longitudinal data shows positive associations between sex work, perceived stigma, and socially less acceptable drug use (for example, heroin and cocaine), and that stigma mediates part of the link between sex work and the use of these drugs. Our overall findings suggest that perceived stigma is pronounced among those who work in the sex industry and negatively affects health independently of sex work involvement. © 2015 Foundation for the Sociology of Health & Illness.

How does stigma affect work in people with serious mental illnesses?

PubMed

Corrigan, Patrick W; Powell, Karina J; Rüsch, Nicolas

2012-09-01

How does stigma influence whether people with serious mental illness work? We examine the relationship of public stigma (the effects that occur when people with mental illness endorse the common prejudice of mental illness) and self-stigma (the results of people with psychiatric disorders internalizing prejudice) on current and lifetime histories of work. Eighty-five persons with serious mental illness reported current work history (i.e., in the past 3 months and in the past year) and lifetime work history (i.e., "have you ever worked?"). They also completed measures of self- and public stigma, focusing on the stereotypes of responsibility and dangerousness. Endorsement of public stigma was shown to be significantly associated with lifetime history of work and self-stigma with current history. The dangerousness cluster of public stigma was specifically associated with lifetime work. We also tested a hierarchical model of self-stigma: that people need to first be aware of the prejudice, then agree to it, next apply it to themselves, and finally experience some harm to self-esteem. Only the latter stages of self-stigma-apply and harm-were correlated with current work. Implications of these findings for meaningfully impacting stigma change are considered. In particular, we discuss ways to change public and self-stigma in order to enhance work. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Effect of neighborhood stigma on economic transactions

PubMed Central

Besbris, Max; Faber, Jacob William; Rich, Peter; Sharkey, Patrick

2015-01-01

The hypothesis of neighborhood stigma predicts that individuals who reside in areas known for high crime, poverty, disorder, and/or racial isolation embody the negative characteristics attributed to their communities and experience suspicion and mistrust in their interactions with strangers. This article provides an experimental test of whether neighborhood stigma affects individuals in one domain of social life: economic transactions. To evaluate the neighborhood stigma hypothesis, this study adopts an audit design in a locally organized, online classified market, using advertisements for used iPhones and randomly manipulating the neighborhood of the seller. The primary outcome under study is the number of responses generated by sellers from disadvantaged relative to advantaged neighborhoods. Advertisements from disadvantaged neighborhoods received significantly fewer responses than advertisements from advantaged neighborhoods. Results provide robust evidence that individuals from disadvantaged neighborhoods bear a stigma that influences their prospects in economic exchanges. The stigma is greater for advertisements originating from disadvantaged neighborhoods where the majority of residents are black. This evidence reveals that residence in a disadvantaged neighborhood not only affects individuals through mechanisms involving economic resources, institutional quality, and social networks but also affects residents through the perceptions of others. PMID:25848041

The experience of stigma among Black mental health consumers.

PubMed

Alvidrez, Jennifer; Snowden, Lonnie R; Kaiser, Dawn M

2008-08-01

Little is known about how stigma affects Black people receiving mental health treatment. For a project to develop a consumer-based stigma intervention, qualitative interviews were conducted with public-sector Black mental health consumers (N=34). Primary themes from the interviews regarding stigma concerns, experiences, and coping strategies were examined. Concerns about stigma prompted most consumers initially to avoid or delay treatment; once in treatment, consumers commonly faced stigmatizing reactions from others. Consumers identified numerous strategies to deal with stigma, including seeking support from accepting members of their existing social networks, and viewing their own health as more important than the reaction of others. These consumer perspectives may be valuable to Black individuals who are contemplating seeking mental health treatment.

Identity threat and stigma in cancer patients

PubMed Central

Marziliano, Allison; Moyer, Anne

2014-01-01

Cancer stigma has undergone an important transformation in recent decades. In general, this disease no longer fits squarely into Goffman’s classic taxonomy of stigmatized conditions. This review will demonstrate that, with important adaptations, an identity-threat model of stigma can be used to organize cancer stigma research post-Goffman. This adapted model postulates that one’s personal attributions, responses to situational threat, and disease/treatment characteristics can be used to predict identity threat and well-being of individuals with cancer. Implications for further research and clinical practice are discussed. PMID:28070343

The role of stigma in parental help-seeking for child behavior problems.

PubMed

Dempster, Robert; Wildman, Beth; Keating, Adam

2013-01-01

The present study examined the relationship between stigma and parental help-seeking after controlling for demographics, child behavior, and barriers to treatment. One hundred fifteen parents of children ages 4 to 8 years were surveyed during well-child visits in a rural pediatric primary care practice. Parental perceptions of stigma toward parents and children were both assessed. Parents believe that children are more likely to be stigmatized by the public and personally impacted by stigma. In linear regression analyses, parents rated themselves as more likely to attend parenting classes with lower levels of self-stigma and greater levels of personal impact of stigma. Stigma toward the child was not associated with help-seeking. Child behavior moderated the relationship between stigma and parental help-seeking. When referring parents to treatment, providers should address potential stigma concerns. Future research should assess both the impact of the stigma of attending treatment and the stigma of having a child with behavior problems.

Does Humor Influence the Stigma of Mental Illnesses?

PubMed Central

Corrigan, Patrick W.; Powell, Karina J.; Fokuo, J. Konadu; Kosyluk, Kristin A.

2014-01-01

Public stigma is a barrier for people with mental illness. Humor may have the potential to decrease stigmatizing attitudes in the context of disclosure. Participants completed measures on stigmatizing attitudes and humor style and were then randomized to one of three conditions (self-disclosure comedy sketch, the same comedy sketch with no disclosure, and a control comedy sketch). After reviewing the comedy sketch, participants repeated the attitude measures and provided perceptions of the comic. Humor styles and perceptions significantly interacted with condition to reduce stigma. Perceptions of the self-disclosed comic were associated with reduced stigma. People exhibiting affiliative humor style (i.e., they enjoy making others laugh) were shown to have significantly greater stigma changes in the disclosed condition compared to the non-disclosed and control conditions. Affiliative humor endorsers also interacted with the non-disclosed condition suggesting that mental health comedy might generally reduce stigma in people who use humor to improve relationships. PMID:24727719

Attentional Bias Associated with Habitual Self-Stigma in People with Mental Illness

PubMed Central

Chan, Kevin K. S.; Mak, Winnie W. S.

2015-01-01

As habitual self-stigma can have a tremendous negative impact on people with mental illness, it is of paramount importance to identify its risk factors. The present study aims to examine the potential contributory role of attentional bias in habitual self-stigma. People with mental illness having strong (n = 47) and weak (n = 47) habitual self-stigma completed a computerized emotional Stroop task which included stigma-related, positive, and non-affective words as stimuli. The strong habit group was found to exhibit faster color-naming of stigma-related words (compared to non-affective words), whereas the weak habit group showed no difference in the speed of response to different stimuli. These findings suggest that people with stronger habitual self-stigma may be more able to ignore the semantic meaning of stigma-related words and focus on the color-naming task. Moreover, people with stronger habitual self-stigma may have greater attentional avoidance of stigma-related material. The present study is the first to demonstrate a specific relationship between habitual self-stigma and biased processing of stigma-related information. In order to further determine the role and the nature of attentional bias in habitual self-stigma, future research should employ a broader range of experimental paradigms and measurement techniques to examine stigma-related attentional bias in people with mental illness. PMID:26177536

Attentional Bias Associated with Habitual Self-Stigma in People with Mental Illness.

PubMed

Chan, Kevin K S; Mak, Winnie W S

2015-01-01

As habitual self-stigma can have a tremendous negative impact on people with mental illness, it is of paramount importance to identify its risk factors. The present study aims to examine the potential contributory role of attentional bias in habitual self-stigma. People with mental illness having strong (n = 47) and weak (n = 47) habitual self-stigma completed a computerized emotional Stroop task which included stigma-related, positive, and non-affective words as stimuli. The strong habit group was found to exhibit faster color-naming of stigma-related words (compared to non-affective words), whereas the weak habit group showed no difference in the speed of response to different stimuli. These findings suggest that people with stronger habitual self-stigma may be more able to ignore the semantic meaning of stigma-related words and focus on the color-naming task. Moreover, people with stronger habitual self-stigma may have greater attentional avoidance of stigma-related material. The present study is the first to demonstrate a specific relationship between habitual self-stigma and biased processing of stigma-related information. In order to further determine the role and the nature of attentional bias in habitual self-stigma, future research should employ a broader range of experimental paradigms and measurement techniques to examine stigma-related attentional bias in people with mental illness.

Defamation & Stigma Claims against Public Employers.

ERIC Educational Resources Information Center

Worona, Jay; Fletcher, Cynthia Plumb

This article, written by two lawyers, defines defamation, discusses the basic law of defamation and stigma, and focuses on recent case law on this topic. The cases are only a sample of the numerous cases that school districts across the nation face on the issues of defamation and stigma. The following topics are included in the legal review: the…

The Stigma of Childhood Mental Disorders: A Conceptual Framework

ERIC Educational Resources Information Center

Mukolo, Abraham; Heflinger, Craig Anne; Wallston, Kenneth A.

2010-01-01

Objective: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. Method: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus…

Gendered aspects of perceived and internalized HIV-related stigma in China.

PubMed

Li, Li; Lin, Chunqing; Ji, Guoping

2017-10-01

Although studies have demonstrated that females experience more HIV-related stigma than males do, questions remain regarding the different dimensions of the stigma (i.e., perceived versus internalized) in China. The present study investigated gender differences in perceived and internalized HIV-related stigma, taking into account the potential influence of education. The study was conducted between October 2011 and March 2013. A total of 522 people living with HIV (PLH) were recruited from Anhui Province, China. The PLH participated in a survey using the Computer Assisted Personal Interview (CAPI) method. The gender differences in perceived and internalized HIV-related stigma were calculated with and without stratifying by education level. Female participants had significantly less education than the male participants. No significant difference was observed between females and males with respect to perceived stigma. However, females reported significantly higher internalized stigma than males did (p < .001). When socio-demographic characteristics were controlled, the gender difference in internalized stigma remained significant among educated participants (p = .038). The findings suggested that gender differences in HIV-related stigma were primarily found for internalized stigma. Heightened intervention efforts are encouraged to reduce internalized HIV-related stigma, particularly among female PLH in China and other regions with similar gender dynamics.

Experiences of mental illness stigma, prejudice and discrimination: a review of measures.

PubMed

Brohan, Elaine; Slade, Mike; Clement, Sarah; Thornicroft, Graham

2010-03-25

There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose.

Perceived stigma by children on antiretroviral treatment in Cambodia.

PubMed

Barennes, Hubert; Tat, Sovann; Reinharz, Daniel; Vibol, Ung

2014-12-10

HIV-related stigma diminishes the quality of life of affected patients. Little is known about perceived and enacted stigma of HIV-infected children in resources-limited settings. We documented the prevalence of perceived stigma and associated factors associated among children on antiretroviral therapy (ART) at a referral hospital in Cambodia. After informed consent, a standardized pre-tested 47-item questionnaire was confidentially administered to consecutive children (7 to 15 years) or their guardians if the child was 18 months to 6 years, during their routine ART visits. The questionnaire explored the sociodemographics of the child and the parents, HIV history, adherence to ART, tolerance of ART and perceived stigma. Associations between perceived stigma and the children's characteristics were measured by bivariate and multivariate analyses. Of 183 children, 101 (55.2%) had lost at least one and 45 (24.6%) both parents; 166 (90.7%) went to school. Of 183 children (female: 84, 45.9%, median age 7.0 years, interquartile range: 2.0-9.6), 79 (43.2%) experienced perceived stigma, including rejection by others (26.8%), no invitations to social activities (18.6%) and exclusion from games (14.2%). A total of 43 (23.5%) children were fearful of their disease and 61 (53.9%) of 113 older than 6 years reported knowledge of their HIV status. Of 136 children over five years and eligible for education, 7 (3.8%) could not go to school due to perceived stigma. Incomplete adherence to ART was reported for 17 (9.2%) children. In multivariate analysis, school attendance (odds ratio [OR]: 3.9; 95% confidence interval [CI]: 2.0-7.9) and income of less than one dollar per person per day (OR: 2.2, 95% CI: 1.1-4.5) were associated with perceived stigma. Conversely, receipt of social support (OR: 0.4, 95% CI 0.2-0.9) was associated with lower risk of perceived stigma. Perceived stigma in pediatric ART patients remains a significant issue in Cambodia. Psychological support and

Gender differences among discrimination & stigma experienced by depressive patients in Pakistan.

PubMed

Khan, Nashi; Kausar, Rukhsana; Khalid, Adeela; Farooq, Anum

2015-01-01

This study aims to examine Gender Difference in the level of Discrimination and Stigma experienced by people diagnosed with Major Depressive Disorder in Pakistan. It was hypothesized that Women diagnosed with Depression are likely to be experiencing more Discrimination and Internalized Stigma in comparison to Men. This is a Cross Sectional Study. Thirty eight patients diagnosed with Major Depressive Disorder recruited from different Government Sector Hospitals of Lahore; were approached after obtaining informed consent. Discrimination and Stigma were measured through Discrimination and Stigma Scale and Internalized Stigma of Mental Illness Inventory respectively. Both Men and Women experience considerably high level of associated Stigma and Discrimination due to their Mental Illness. However, Women in comparison to Men experience significantly greater level of Internalized Stigma especially in domains of Discrimination Experience and Social Withdrawal. The findings of this study highlight the fact that people with Depression can be more benefited with psychological treatment if dealing with Stigma and Discrimination is also addressed in Intervention Plans.

The Downside of Tobacco Control? Smoking and Self-Stigma: A systematic review

PubMed Central

Evans-Polce, Rebecca J.; Castaldelli-Maia, Joao M.; Schomerus, Georg; Evans-Lacko, Sara E.

2015-01-01

Objective Little is known about the consequences of tobacco smoking stigma on smokers and how smokers may internalize smoking-related stigma. This review summarizes existing literature on tobacco smoking self-stigma, investigating to what extent smokers are aware of negative stereotypes, agree with them and apply them to themselves. Methods We carried out a systematic search of Pubmed/Web of Science/PsycInfo databases for articles related to smoking self-stigma through June 2013. Reference lists and citations of included studies were also checked and experts were contacted. After screening articles for inclusion/exclusion criteria we performed a quality assessment and summarized findings according to the stages of self-stigma as conceptualized in Corrigan’s progressive model of self-stigma (aware, agree, apply and harm). Initial searches yielded 570 articles. Results Thirty of these articles (18 qualitative and 12 quantitative studies) met criteria for our review. Awareness of smoking stigma was virtually universal across studies. Coping strategies for smoking stigma and the degree to which individuals who smoke internalized this stigma varied both within and across studies. There was considerable variation in positive, negative, and non-significant consequences associated with smoking self-stigma. Limited evidence was found for subgroup differences in smokingrelated stigma. Conclusion While there is some evidence that smoking self-stigma leads to reductions in smoking, this review also identified significant negative consequences of smoking self-stigma. Future research should assess the factors related to differences in how individuals respond to smoking stigma. Public health strategies which limit the stigmatization of smokers may be warranted. PMID:26439764

Measuring mental illness stigma with diminished social desirability effects.

PubMed

Michaels, Patrick J; Corrigan, Patrick W

2013-06-01

For persons with mental illness, stigma diminishes employment and independent living opportunities as well as participation in psychiatric care. Public stigma interventions have sought to ameliorate these consequences. Evaluation of anti-stigma programs' impact is typically accomplished with self-report questionnaires. However, cultural mores encourage endorsement of answers that are socially preferred rather than one's true belief. This problem, social desirability, has been circumvented through development of faux knowledge tests (KTs) (i.e., Error-Choice Tests); written to assess prejudice. Our KT uses error-choice test methodology to assess stigmatizing attitudes. Test content was derived from review of typical KTs for façade reinforcement. Answer endorsement suggests bias or stigma; such determinations were based on the empirical literature. KT psychometrics were examined in samples of college students, community members and mental health providers and consumers. Test-retest reliability ranged from fair (0.50) to good (0.70). Construct validity analyses of public stigma indicated a positive relationship with the Attribution Questionnaire and inverse relationships with Self-Determination and Empowerment Scales. No significant relationships were observed with self-stigma measures (recovery, empowerment). This psychometric evaluation study suggests that a self-administered questionnaire may circumvent social desirability and have merit as a stigma measurement tool.

Understanding stigma in chronic health conditions: implications for nursing.

PubMed

Engebretson, Joan

2013-10-01

This article explores the social processes in stigmatization and the theoretical background on the impact in chronic illness. Review of literature from social sciences and applications to health issues. Understanding the social utility of stigmatization in preserving social cohesion and protecting the social order is an important function. However, this process can be harmful when applied to persons with chronic illness, such as HIV-AIDS, and psychiatric illness. These individuals often become shamed, ostracized, isolated, discredited, and socially and economically marginalized. Recent theoretical work on stigma has identified several issues and patient responses that may have implications in many other chronic conditions. Stigma is based on visible or nonvisible health conditions and can be both externally imposed or perceived in a process of self-stigma. Understanding stigma can aid clinicians in providing supportive help for patients with chronic illness. Stigma has been well researched in a few chronic illnesses; however, future studies in other conditions are much needed. Recognizing the underlying social factors has potential use in health-promoting behaviors. Sensitivity to stigma allows health professionals to critically reflect on ways the healthcare environment may add to stigma for their patients. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Stigma and Racial/Ethnic HIV Disparities: Moving toward Resilience

ERIC Educational Resources Information Center

Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, David R.

2013-01-01

Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce…

Understanding HIV-related stigma among Indonesian nurses

PubMed Central

Waluyo, Agung; Culbert, Gabriel J.; Levy, Judith; Norr, Kathleen

2014-01-01

Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country’s policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses’ HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses’ stigmatizing attitudes toward PLWH. Four hundred nurses recruited from 4 hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale (NAAS) to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. PMID:24759060

Mental illness--stigma and discrimination in Zambia.

PubMed

Kapungwe, A; Cooper, S; Mwanza, J; Mwape, L; Sikwese, A; Kakuma, R; Lund, C; Flisher, A J

2010-07-01

The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. In Zambia, as in many other low-income African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue.

Stigma in patients with rectal cancer: a community study.

PubMed Central

MacDonald, L D; Anderson, H R

1984-01-01

A self-rating measure of stigma and several supplementary questions were devised in order to assess perceived stigma in a community survey of the quality of life in 420 rectal cancer patients, of whom 265 had a permanent colostomy. Half the patients felt stigmatised, higher proportions being observed among younger patients and among those with a colostomy. Feelings of stigma were associated with poor health, particularly emotional disorders, with the presence of other medical problems, and with disablement. Patients who perceived stigma made more use of medical services but were less satisfied with them, particularly with regard to communication with health professionals. Socio-economic factors, such as employment status, higher income, and higher social and housing class, did not protect patients against feeling stigmatised by cancer or by colostomy. Most patients, with or without stigma, enjoyed close relationships with intimates, but the stigmatised were more likely to have withdrawn from participation in social activities. Assessing stigma by self-rating gives information which adds to that obtained by the usual methods of assessing quality of life. PMID:6512480

An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index

PubMed Central

2014-01-01

Background The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV). Methods The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data. Results Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status. Conclusion The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study. PMID:24461042

An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index.

PubMed

Dos Santos, Monika Ml; Kruger, Pieter; Mellors, Shaun E; Wolvaardt, Gustaaf; van der Ryst, Elna

2014-01-27

The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV). The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data. Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status. The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study.

Reducing the stigma associated with seeking psychotherapy through self-affirmation.

PubMed

Lannin, Daniel G; Guyll, Max; Vogel, David L; Madon, Stephanie

2013-10-01

Psychotherapy may be underutilized because people experience self-stigma-the internalization of public stigma associated with seeking psychotherapy. The purpose of this study was to experimentally test whether the self-stigma associated with seeking psychotherapy could be reduced by a self-affirmation intervention wherein participants reflected on an important personal characteristic. Compared with a control group, we hypothesized that a self-affirmation writing task would attenuate self-stigma, and thereby evidence indirect effects on intentions and willingness to seek psychotherapy. Participants were 84 undergraduates experiencing psychological distress. After completing pretest measures of self-stigma, intentions, and willingness to seek psychotherapy, participants were randomly assigned to either a self-affirmation or a control writing task, and subsequently completed posttest measures of self-stigma, intentions, and willingness to seek psychotherapy. Consistent with hypotheses, participants who engaged in self-affirmation reported lower self-stigma at posttest. Moreover, the self-affirmation writing task resulted in a positive indirect effect on willingness to seek psychotherapy, though results failed to support an indirect effect on intentions to seek psychotherapy. Findings suggest that self-affirmation theory may provide a useful framework for designing interventions that seek to address the underutilization of psychological services through reductions in self-stigma.

HIV in Harare: the role and relevance of social stigma.

PubMed

O'Brien, Stephen; Broom, Alex

2014-01-01

HIV is a significant social, political and economic problem in Zimbabwe. However, few researchers have explored peoples' experiences of living with HIV in that country. Drawing on 60 qualitative interviews conducted with Zimbabweans living in Harare in 2010, this paper focuses on how people from four different urban communities cope with HIV-related social stigma. To provide theoretical context to this issue, we utilised the ideas of Erving Goffman for exploring the individual experience of stigma and the concept of structural violence to understand stigma as a social phenomenon. This paper considers the relevance and role of stigma in the context of a country undergoing significant social, political and economic crisis. We investigated the strategies adopted by the Zimbabwean state and the influence of traditional and religious interpretations to appreciate the historical roots of HIV-related stigma. We took into account the ways in which the articulation of HIV with gender has caused women to experience stigma differently than men, and more intensely, and how grassroots activism and biomedical technologies have transformed the experience of stigma.

Changes of Explicit and Implicit Stigma in Medical Students during Psychiatric Clerkship.

PubMed

Wang, Peng-Wei; Ko, Chih-Hung; Chen, Cheng-Sheng; Yang, Yi-Hsin Connine; Lin, Huang-Chi; Cheng, Cheng-Chung; Tsang, Hin-Yeung; Wu, Ching-Kuan; Yen, Cheng-Fang

2016-04-01

This study examines the differences in explicit and implicit stigma between medical and non-medical undergraduate students at baseline; the changes of explicit and implicit stigma in medical undergraduate and non-medical undergraduate students after a 1-month psychiatric clerkship and 1-month follow-up period; and the differences in the changes of explicit and implicit stigma between medical and non-medical undergraduate students. Seventy-two medical undergraduate students and 64 non-medical undergraduate students were enrolled. All participants were interviewed at intake and after 1 month. The Taiwanese version of the Stigma Assessment Scale and the Implicit Association Test were used to measure the participants' explicit and implicit stigma. Neither explicit nor implicit stigma differed between two groups at baseline. The medical, but not the non-medical, undergraduate students had a significant decrease in explicit stigma during the 1-month period of follow-up. Neither the medical nor the non-medical undergraduate students exhibited a significant change in implicit stigma during the one-month of follow-up, however. There was an interactive effect between group and time on explicit stigma but not on implicit stigma. Explicit but not implicit stigma toward mental illness decreased in the medical undergraduate students after a psychiatric clerkship. Further study is needed to examine how to improve implicit stigma toward mental illness.

Gender, HIV Testing and Stigma: The Association of HIV Testing Behaviors and Community-Level and Individual-Level Stigma in Rural South Africa Differ for Men and Women.

PubMed

Treves-Kagan, Sarah; El Ayadi, Alison M; Pettifor, Audrey; MacPhail, Catherine; Twine, Rhian; Maman, Suzanne; Peacock, Dean; Kahn, Kathleen; Lippman, Sheri A

2017-09-01

Stigma remains a significant barrier to HIV testing in South Africa. Despite being a social construct, most HIV-stigma research focuses on individuals; further the intersection of gender, testing and stigma is yet to be fully explored. We examined the relationship between anticipated stigma at individual and community levels and recent testing using a population-based sample (n = 1126) in Mpumalanga, South Africa. We used multi-level regression to estimate the potential effect of reducing community-level stigma on testing uptake using the g-computation algorithm. Men tested less frequently (OR 0.22, 95% CI 0.14-0.33) and reported more anticipated stigma (OR 5.1, 95% CI 2.6-10.1) than women. For men only, testing was higher among those reporting no stigma versus some (OR 1.40, 95% CI 0.97-2.03; p = 0.07). For women only, each percentage point reduction in community-level stigma, the likelihood of testing increased by 3% (p < 0.01). Programming should consider stigma reduction in the context of social norms and gender to tailor activities appropriately.

Internalized stigma in people with severe mental illness in rural China.

PubMed

Ran, Mao-Sheng; Zhang, Tian-Ming; Wong, Irene Yin-Ling; Yang, Xin; Liu, Chang-Cheng; Liu, Bo; Luo, Wei; Kuang, Wei-Hong; Thornicroft, Graham; Chan, Cecilia Lai-Wan

2018-02-01

It is unknown whether there are differences in self-stigma among persons with different types of severe mental illness (SMI) in rural communities. This study was to examine the differences of self-stigma and its correlates in persons with schizophrenia, major depressive disorder or bipolar disorder in a rural community in China. A total of 453 persons with schizophrenia, major depressive disorder or bipolar disorder in a rural community participated in the study. The Internalized Stigma of Mental Illness (ISMI) was used to measure self-stigma. The t-test and analyses of variance (ANOVA) were used to examine the differences in mean scores of ISMI and subscales among the three diagnoses. Logistic regression was used to explore the contributing factors to the level of self-stigma among the three groups. Self-stigma was moderate and severe with 94.7% of the total sample. Persons with schizophrenia had significantly higher mean scores of total ISMI, alienation and discrimination experience than those with bipolar disorders. Lower family income was significantly associated with higher levels of self-stigma in persons with schizophrenia and major depressive disorder. Factors predicting the level of self-stigma among the three groups were various. Self-stigma is common and severe in persons with schizophrenia, major depressive disorder and bipolar disorder, especially those with lower income status in rural community in China. Persons with schizophrenia may have higher levels of self-stigma than those with bipolar disorder. Individual-level interventions should be developed to reduce self-stigma among persons with SMI in Chinese rural communities.

The generalised anxiety stigma scale (GASS): psychometric properties in a community sample

PubMed Central

2011-01-01

Background Although there is substantial concern about negative attitudes to mental illness, little is known about the stigma associated with Generalised Anxiety Disorder (GAD) or its measurement. The aim of this study was to develop a multi-item measure of Generalised Anxiety Disorder stigma (the GASS). Methods Stigma items were developed from a thematic analysis of web-based text about the stigma associated with GAD. Six hundred and seventeen members of the public completed a survey comprising the resulting 20 stigma items and measures designed to evaluate construct validity. Follow-up data were collected for a subset of the participants (n = 212). Results The factor structure comprised two components: Personal Stigma (views about Generalised Anxiety Disorder); and Perceived Stigma (views about the beliefs of most others in the community). There was evidence of good construct validity and reliability for each of the Generalised Anxiety Stigma Scale (GASS) subscales. Conclusions The GASS is a promising brief measure of the stigma associated with Generalised Anxiety Disorder. PMID:22108099

Intersections of Stigma, Mental Health, and Sex Work: How Canadian Men Engaged in Sex Work Navigate and Resist Stigma to Protect Their Mental Health.

PubMed

Jiao, Sunny; Bungay, Vicky

2018-05-01

Men engaged in sex work experience significant stigma that can have devastating effects for their mental health. Little is known about how male sex workers experience stigma and its effects on mental health or their strategies to prevent its effects in the Canadian context. This study examined the interrelationships between stigma and mental health among 33 Canadian indoor, male sex workers with a specific goal of understanding how stigma affected men's mental health and their protective strategies to mitigate against its effects. Men experienced significant enacted stigma that negatively affected their social supports and ability to develop and maintain noncommercial, romantic relationships. Men navigated stigma by avoidance and resisting internalization. Strategy effectiveness to promote mental health varied based on men's perspectives of sex work as a career versus a forced source of income. Programming to promote men's mental health must take into consideration men's diverse strategies and serve to build social supports.

Comparative Analysis of Native Crocus Taxa as a Great Source of Flavonoids with High Antioxidant Activity.

PubMed

Šola, Ivana; Stipaničev, Mirta; Vujčić, Valerija; Mitić, Božena; Huđek, Ana; Rusak, Gordana

2018-06-02

Native Crocus taxa are abundant in regions with moderate and dry climate; however, their potential in the food industry has thus far been neglected. The objective of this study was to compare the quantitative and qualitative flavonoid content and antioxidant and cytotoxic activity in organs of several populations of Croatian native taxa and assess their potential for application in the food industry. The dominant flavonoids in the native Crocus taxa were kaempferol and quercetin. Tepals contained similar or higher concentrations of flavonoid-glycosides than other organs. Tepals from Cvv1 and Cvv2 populations contained more flavonoid-glycosides than the commonly used spice saffron (C. sativus stigmas). The FRAP antioxidant activity of Cvv1 and Cvv5 tepals was similar to that of standard Trolox. DPPH inhibition of Cvv1 and Cvv3 tepals was within the range of that recorded for saffron. Cvv1 tepals significantly reduced reactive oxygen species in the broadest concentration range (50-1000 μg/ml), and showed considerable antioxidant activity in the ABTS assay, equal to 82% of standard Trolox antioxidant activity. A significantly higher concentration of kaempferol-rutinoside was recorded in this than in other taxa. The flavonoid showed a very strong or strong correlation with antioxidant assays results, and a negative correlation with cellular reactive oxygen species concentration. We therefore presumed that kaempferol-rutinoside is one of the main antioxidant phenolics in Crocus tepals. None of the tested extracts showed cytotoxicity toward Caco-2 cells. The results revealed that Cvv tepals have potential as a food supplement and are a promising material for further food safety tests.

The Development of an Empirical Model of Mental Health Stigma in Adolescents.

PubMed

Silke, Charlotte; Swords, Lorraine; Heary, Caroline

2016-08-30

Research on mental health stigma in adolescents is hampered by a lack of empirical investigation into the theoretical conceptualisation of stigma, as well as by the lack of validated stigma measures. This research aims to develop a model of public stigma toward depression in adolescents and to use this model to empirically examine whether stigma is composed of three separate dimensions (Stereotypes, Prejudice and Discrimination), as is theoretically proposed. Adolescents completed self-report measures assessing their stigmatising responses toward a fictional peer with depression. An exploratory factor analysis (EFA; N=332) was carried out on 58-items, which proposed to measure aspects of stigma. A confirmatory factor analysis (CFA; N=236) was then carried out to evaluate the validity of the observed stigma model. Finally, higher-order CFAs were conducted in order to assess whether the observed model supported the tripartite conceptualisation of stigma. The EFA returned a seven-factor model of stigma. These factors were designated as Dangerousness, Warmth & Competency, Responsibility, Negative Attributes, Prejudice, Classroom Discrimination and Friendship Discrimination. The CFA supported the goodness-of-fit of this seven-factor model. The higher-order CFAs indicated that these seven factors represented the latent constructs of, Stereotypes, Prejudice and Discrimination, which in turn represented Stigma. Overall, results support the tripartite conceptualisation of stigma and suggest that measurements of mental health stigma in adolescents should include assessments of all three dimensions. These results also highlight the importance of establishing valid and reliable measures for assessing stigma in adolescents. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stigma Among Survivors of Sexual Violence in Congo: Scale Development and Psychometrics.

PubMed

Murray, Sarah McIvor; Robinette, Katie L; Bolton, Paul; Cetinoglu, Talita; Murray, Laura K; Annan, Jeannie; Bass, Judith K

2018-02-01

Stigma related to sexual violence (SV) is associated with many negative physical and social outcomes. We sought to create a contextually relevant measure of SV-related stigma for women in the Democratic Republic of Congo (DRC) and assess itspsychometrics and validity. Using baseline screening data from two randomized controlled trials of services for female SV survivors in Eastern DRC ( n = 1,184), we conducted exploratory and confirmatory factor analyses to test the measurement model. Cronbach's alphas and Kuder-Richardson 20 (KR-20) statistics were used to evaluate internal consistency. Logistic and linear regressions of the stigma measures with related constructs were used to assess construct validity. Two distinct but related scales were developed based on factor analyses: a four-item scale of discrimination-related stigma (i.e., enacted stigma) and an eight-item scale of combined perceived and internalized stigma (i.e., felt stigma). Both scales showed good internal consistency (KR-20 = .68; α = .86). A higher felt stigma score was associated with significant increases in combined depression and anxiety and trauma symptoms, as well as functional impairment ( p < .001). Having a child as a result of SV was associated with both significantly higher enacted and felt stigma ( p < .001). Neither SV stigma scale was associated with medical care seeking. To address harmful ramifications of stigma among SV survivors, locally relevant quantitative measures are necessary to understand the nature and severity of stigma they experience. Our process of scale creation and evaluation can serve as an example for developing locally relevant SV-related stigma measures.

Connection between self-stigma, adherence to treatment, and discontinuation of medication

PubMed Central

Kamaradova, Dana; Latalova, Klara; Prasko, Jan; Kubinek, Radim; Vrbova, Kristyna; Mainerova, Barbora; Cinculova, Andrea; Ociskova, Marie; Holubova, Michaela; Smoldasova, Jarmila; Tichackova, Anezka

2016-01-01

Introduction Self-stigma plays a role in many areas of the patient’s life. Furthermore, it also discourages therapy. The aim of our study was to examine associations between self-stigma and adherence to treatment and discontinuation of medication in patients from various diagnostic groups. Methods This cross-sectional study involved outpatients attending the Department of Psychiatry, University Hospital Olomouc, Czech Republic. The level of self-stigma was measured with the Internalized Stigma of Mental Illness and adherence with the Drug Attitude Inventory. The patients also anonymously filled out a demographic questionnaire which included a question asking whether they had discontinued their medication in the past. Results We examined data from 332 patients from six basic diagnostic categories (substance abuse disorders, schizophrenia, bipolar disorders, depressive disorders, anxiety disorders, and personality disorders). The study showed a statistically significant negative correlation between self-stigma and adherence to treatment in all diagnostic groups. Self-stigma correlated positively and adherence negatively with the severity of disorders. Another important factor affecting both variables was partnership. Self-stigma positively correlated with doses of antidepressants and adherence with doses of anxiolytics. Self-stigma also negatively correlated with education, and positively with a number of hospitalizations and number of psychiatrists visited. Adherence was further positively correlated with age and age of onset of disorders. Regression analysis showed that self-stigma was an important factor negatively influencing adherence to treatment and significantly contributing to voluntary discontinuation of drugs. The level of self-stigma did not differ between diagnostic categories. Patients suffering from schizophrenia had the lowest adherence to treatment. Conclusion The study showed a significant correlation between self-stigma and adherence to treatment

The stigma of mental health problems in the military.

PubMed

Greene-Shortridge, Tiffany M; Britt, Thomas W; Castro, Carl Andrew

2007-02-01

The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals with psychological problems, leading to potential discrimination toward these individuals. The internalization of these negative beliefs results in self-stigma, leading to reduced self-esteem and motivation to seek help. Even if soldiers form an intention to seek help for their psychological difficulty, barriers to mental health care may prevent the soldier from receiving the help they need. An overall model is proposed to illustrate how the stigma associated with psychological problems can prevent soldiers getting needed help for psychological difficulties and proposed interventions for reducing stigma in a civilian context are considered for military personnel.

Stigma and stereotypes: women and sexually transmitted infections.

PubMed

East, Leah; Jackson, Debra; O'Brien, Louise; Peters, Kathleen

2012-01-01

Sexually transmitted infections have long been associated with stigma and stereotypes due to their very nature. Throughout history sexually transmitted infections have been associated with female prostitution and deviant immoral behaviour making women who contract these infections particularly vulnerable to being stigmatised and stereotyped. Although the stigma attached to such infections has previously been documented in the literature, the aim of this research was to gain in depth insight into young Australian women's experiences of having a sexually transmitted infection from a feminist perspective. Findings from this study provide insight into the onerous effects stigma can have on women with these infections and sheds light on how these effects can influence self-perceptions, fear of rejection and feelings of unworthiness. These findings can provide nurses with greater understanding and insight into the effects of stigma on women's experiences of having a sexually transmitted infection. Having this understanding and insight has the potential to promote therapeutic care and minimise the stigma that may be felt among women who have contracted this type of infection.

Gender differences among discrimination & stigma experienced by depressive patients in Pakistan

PubMed Central

Khan, Nashi; Kausar, Rukhsana; Khalid, Adeela; Farooq, Anum

2015-01-01

Objective: This study aims to examine Gender Difference in the level of Discrimination and Stigma experienced by people diagnosed with Major Depressive Disorder in Pakistan. It was hypothesized that Women diagnosed with Depression are likely to be experiencing more Discrimination and Internalized Stigma in comparison to Men. Methods: This is a Cross Sectional Study. Thirty eight patients diagnosed with Major Depressive Disorder recruited from different Government Sector Hospitals of Lahore; were approached after obtaining informed consent. Discrimination and Stigma were measured through Discrimination and Stigma Scale and Internalized Stigma of Mental Illness Inventory respectively. Results: Both Men and Women experience considerably high level of associated Stigma and Discrimination due to their Mental Illness. However, Women in comparison to Men experience significantly greater level of Internalized Stigma especially in domains of Discrimination Experience and Social Withdrawal. Conclusion: The findings of this study highlight the fact that people with Depression can be more benefited with psychological treatment if dealing with Stigma and Discrimination is also addressed in Intervention Plans. PMID:26870110

Understanding HIV-related stigma among Indonesian nurses.

PubMed

Waluyo, Agung; Culbert, Gabriel J; Levy, Judith; Norr, Kathleen F

2015-01-01

Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country's policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses' HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses' stigmatizing attitudes toward PLWH. Four hundred nurses recruited from four hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Stigma of Suicide Attempt (STOSA) scale and Stigma of Suicide and Suicide Survivor (STOSASS) scale: two new assessment tools.

PubMed

Scocco, Paolo; Castriotta, Cristina; Toffol, Elena; Preti, Antonio

2012-12-30

This study aimed at validating two new assessment tools, the Stigma of Suicide Attempt (STOSA) scale and the Stigma of Suicide and Suicide Survivor (STOSASS) scale. The Devaluation-Discrimination scale of Link et al. was translated into Italian and adapted to measure stigma towards suicidal behavior. Both scales were administered to a mixed sample including members of the general population (n=282), patients with a mental disorder (n=113), suicide attempters (n=57) and people who had lost a significant other to suicide (n=75). Reliability of the scales was good in terms of both internal coherence and test-retest stability. Factor analysis produced an acceptable solution for the STOSA-scale. Items were distributed into two factors, one grouping items to measure supportive, respectful and caring attitudes, the other factor grouping items oriented towards stigmatizing attitudes and beliefs. The clinical populations were more inclined towards stigmatization of suicide than were people from the general population, who might be less aware of the stigma attached to suicide. The two scales may be helpful to quantify stigma at individual level in order to provide targeted supportive interventions, and at population level to measure changes in the beliefs and attitudes of the general population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children's representations of poverty and AIDS

PubMed Central

Campbell, C; Skovdal, M; Mupambireyi, Z; Madanhire, C; Robertson, L; Nyamukapa, C A; Gregson, S

2012-01-01

Objective We use children's drawings to investigate social stigmatization of AIDS-affected and poverty-affected children by their peers, in the light of suggestions that the stigmatization of AIDS-affected children might derive more from the poverty experienced by these children than from their association with AIDS. Methods A qualitative study, in rural Zimbabwe, used draw-and-write techniques to elicit children's (10–12 years) representations of AIDS-affected children (n= 30) and poverty-affected children (n= 33) in 2009 and 2010 respectively. Results Representations of children affected by AIDS and by poverty differed significantly. The main problems facing AIDS-affected children were said to be the psychosocial humiliations of AIDS stigma and children's distress about sick relatives. Contrastingly, poverty-affected children were depicted as suffering from physical and material neglect and deprivation. Children affected by AIDS were described as caregivers of parents whom illness prevented from working. This translated into admiration and respect for children's active contribution to household survival. Poverty-affected children were often portrayed as more passive victims of their guardians' inability or unwillingness to work or to prioritize their children's needs, with these children having fewer opportunities to exercise agency in response to their plight. Conclusions The nature of children's stigmatization of their AIDS-affected peers may often be quite distinct from poverty stigma, in relation to the nature of suffering (primarily psychosocial and material respectively), the opportunities for agency offered by each affliction, and the opportunities each condition offers for affected children to earn the respect of their peers and community. We conclude that the particular nature of AIDS stigma offers greater opportunities for stigma reduction than poverty stigma. PMID:21985490

Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children's representations of poverty and AIDS.

PubMed

Campbell, C; Skovdal, M; Mupambireyi, Z; Madanhire, C; Robertson, L; Nyamukapa, C A; Gregson, S

2012-09-01

We use children's drawings to investigate social stigmatization of AIDS-affected and poverty-affected children by their peers, in the light of suggestions that the stigmatization of AIDS-affected children might derive more from the poverty experienced by these children than from their association with AIDS. A qualitative study, in rural Zimbabwe, used draw-and-write techniques to elicit children's (10-12 years) representations of AIDS-affected children (n= 30) and poverty-affected children (n= 33) in 2009 and 2010 respectively. Representations of children affected by AIDS and by poverty differed significantly. The main problems facing AIDS-affected children were said to be the psychosocial humiliations of AIDS stigma and children's distress about sick relatives. Contrastingly, poverty-affected children were depicted as suffering from physical and material neglect and deprivation. Children affected by AIDS were described as caregivers of parents whom illness prevented from working. This translated into admiration and respect for children's active contribution to household survival. Poverty-affected children were often portrayed as more passive victims of their guardians' inability or unwillingness to work or to prioritize their children's needs, with these children having fewer opportunities to exercise agency in response to their plight. The nature of children's stigmatization of their AIDS-affected peers may often be quite distinct from poverty stigma, in relation to the nature of suffering (primarily psychosocial and material respectively), the opportunities for agency offered by each affliction, and the opportunities each condition offers for affected children to earn the respect of their peers and community. We conclude that the particular nature of AIDS stigma offers greater opportunities for stigma reduction than poverty stigma. © 2011 Blackwell Publishing Ltd.

Mental Illness Stigma Expressed by Police to Police.

PubMed

Stuart, Heather

2017-01-01

This paper describes mental health related stigma expressed by police to police using a newly developed 11-item Police Officer Stigma Scale and reports on the preliminary psychometric properties (factor structure and internal reliability) of this scale. The scale used an indirect measurement approach adapted from the Perceived Devaluation and Discrimination Scale. Five themes appropriate to police culture were adapted and six additional items were added. Responses were rated on a 5-point agreement scale with an additional don't know option. Data were collected from officers attending a mandatory workshop (90.5% response). Exploratory factor analysis showed the scale to be unidimensional and internally reliable (Cronbach's alpha was 0.82). The most endorsed items pertained to avoiding disclosure to a supervisor/manager or to a colleague (85% agreement), that most officers would expect discrimination at work (62%), and that most officers would not want a supervisor or manager who had a mental illness (62%). Findings highlight that (a) Police-to-police mental illness stigma may be a particularly strong feature of police cultures; (b) police should be a focus for targeted anti-stigma interventions; and (c) though further psychometric testing is needed, the Police Office Stigma Scale may provide important insights into the nature and functioning of police-to-police stigma in police cultures in future research.

Self-Stigma in Substance Abuse: Development of a New Measure

PubMed Central

Luoma, Jason B.; Nobles, Richard H.; Drake, Chad E.; Hayes, Steven C.; O’Hair, Alyssa; Fletcher, Lindsay; Kohlenberg, Barbara S.

2012-01-01

Little attention has been paid to the examination and measurement of self-stigma in substance misuse. This paper aims to fill this gap by reporting on the development of a new scale to measure self-stigma experienced by people who are misusing substances, the Substance Abuse Self-Stigma Scale. Content validity and item refinement occurred through an iterative process involving a literature search, focus groups, and expert judges. Psychometric properties were examined in a cross-sectional study of individuals (n = 352) receiving treatment for substance misuse. Factor analyses resulted in a 40-item measure with self devaluation, fear of enacted stigma, stigma avoidance, and values disengagement subscales. The measure showed a strong factor structure and good reliability and validity overall, though the values disengagement subscale showed a mixed pattern. Results are discussed in terms of their implications for studies of stigma impact and intervention. PMID:23772099

Interventions targeting mental health self-stigma: A review and comparison.

PubMed

Yanos, Philip T; Lucksted, Alicia; Drapalski, Amy L; Roe, David; Lysaker, Paul

2015-06-01

With growing awareness of the impact of mental illness self-stigma, interest has arisen in the development of interventions to combat it. The present article briefly reviews and compares interventions targeting self-stigma to clarify the similarities and important differences between the interventions. We conducted a narrative review of published literature on interventions targeting self-stigma. Six intervention approaches (Healthy Self-Concept, Self-Stigma Reduction Program, Ending Self-Stigma, Narrative Enhancement and Cognitive Therapy, Coming Out Proud, and Anti-Stigma Photo-Voice Intervention) were identified and are discussed, and data is reviewed on format, group-leader backgrounds, languages, number of sessions, primary mechanisms of action, and the current state of data on their efficacy. We conclude with a discussion of common elements and important distinctions between the interventions and a consideration of which interventions might be best suited to particular populations or settings. (c) 2015 APA, all rights reserved).

An Intersectional Analysis of Women's Experiences of Smoking-Related Stigma.

PubMed

Triandafilidis, Zoi; Ussher, Jane M; Perz, Janette; Huppatz, Kate

2017-08-01

In this article, we explore how young women encounter and counter discourses of smoking-related stigma. Twenty-seven young Australian women, smokers and ex-smokers, took part in interviews. A sub-sample of 18 participants took photographs to document their smoking experience, and took part in a second interview. Data were analyzed through Foucauldian discourse analysis. Four discourses were identified: "smoking as stigmatized," "the smoking double standard," "smoking as lower class," and "smokers as bad mothers." The women negotiated stigma in a variety of ways, shifting between agreeing, disagreeing, challenging, and displacing stigma onto "other" smokers. These experiences and negotiations of smoking-related stigma were shaped by intersecting identities, including gender, cultural background, social class, and mothering, which at times, compounded levels of stigmatization. It is concluded that tobacco control measures should consider the negative implications of smoking-related stigma, and the potential for women to experience compounding levels of stigma.

Psychiatric stigma and discrimination in South Africa: perspectives from key stakeholders.

PubMed

Egbe, Catherine O; Brooke-Sumner, Carrie; Kathree, Tasneem; Selohilwe, One; Thornicroft, Graham; Petersen, Inge

2014-07-04

Stigma and discrimination against people with mental illness remain barriers to help seeking and full recovery for people in need of mental health services. Yet there is scarce research investigating the experiences of psychiatric stigma on mental health service users in low- and middle-income countries (LMICs). The aim of this study was therefore to explore the experiences of psychiatric stigma by service users in order to inform interventions to reduce such stigma and discrimination in one LMIC, namely South Africa. Participants comprised a total of 77 adults aged above 18 years, made up of service providers including professional nurses (10), lay counsellors (20), auxiliary social workers (2); and service users (45). Psychiatric stigma was found to be perpetuated by family members, friends, employers, community members and health care providers. Causes of psychiatric stigma identified included misconceptions about mental illness often leading to delays in help-seeking. Experiencing psychiatric stigma was reported to worsen the health of service users and impede their capacity to lead and recover a normal life. Media campaigns and interventions to reduce stigma should be designed to address specific stigmatizing behaviours among specific segments of the population. Counselling of families, caregivers and service users should include how to deal with experienced and internalized stigma.

Psychiatric stigma and discrimination in South Africa: perspectives from key stakeholders

PubMed Central

2014-01-01

Background Stigma and discrimination against people with mental illness remain barriers to help seeking and full recovery for people in need of mental health services. Yet there is scarce research investigating the experiences of psychiatric stigma on mental health service users in low- and middle-income countries (LMICs). The aim of this study was therefore to explore the experiences of psychiatric stigma by service users in order to inform interventions to reduce such stigma and discrimination in one LMIC, namely South Africa. Methods Participants comprised a total of 77 adults aged above 18 years, made up of service providers including professional nurses (10), lay counsellors (20), auxiliary social workers (2); and service users (45). Results Psychiatric stigma was found to be perpetuated by family members, friends, employers, community members and health care providers. Causes of psychiatric stigma identified included misconceptions about mental illness often leading to delays in help-seeking. Experiencing psychiatric stigma was reported to worsen the health of service users and impede their capacity to lead and recover a normal life. Conclusion Media campaigns and interventions to reduce stigma should be designed to address specific stigmatizing behaviours among specific segments of the population. Counselling of families, caregivers and service users should include how to deal with experienced and internalized stigma. PMID:24996420

Stigma Associated with Classical Congenital Adrenal Hyperplasia in Women's Sexual Lives.

PubMed

Meyer-Bahlburg, Heino F L; Khuri, Jananne; Reyes-Portillo, Jazmin; Ehrhardt, Anke A; New, Maria I

2018-05-01

The risk of intersex-related stigma often serves as social indication for "corrective" genital surgery, but has not been comprehensively documented. In preparation for the development of an intersex-specific stigma assessment tool, this qualitative project aimed to explore stigma in girls and women with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. As part of a comprehensive follow-up project, 62 adult women with classical CAH (age range 18-51 years) took part in an open-ended retrospective interview focusing on the impact of CAH and its treatment on various aspects of girls' and women's lives. Deductive qualitative content analysis (Patton, 2014) of de-identified transcripts involved categorization of three types of stigma: experienced, anticipated, and internalized. Two-fifths of the participants reported CAH-related stigma in romantic/sexual situations. Stigma enactment by romantic partners occurred in reaction to both genital and non-genital sex-atypical features of CAH and sometimes included explicit questioning of the women's true gender. Stigma anticipation by the women and their related avoidance of nudity, genital exposure, and romantic involvement altogether were frequent. Internalization of stigma occurred as well. In conclusion, the data suggest that many women with CAH experience, anticipate, and/or internalize intersex-related stigma in the context of their romantic/sexual lives.

The Stigma of Failure in Organizations

DTIC Science & Technology

2008-01-15

divisions, suggests why the stigma of failure may not always apply in public-sector organizations, and suggests why the development of entrepreneurship ...within organizations may be path- dependent. 14. SUBJECT TERMS Corporate entrepreneurship , stigma of failure 15. NUMBER OF PAGES 59 16. PRICE...of failure may not always apply in public-sector organizations, and suggests why the development of entrepreneurship within organizations may be

Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form.

PubMed

Kisala, Pamela A; Tulsky, David S; Pace, Natalie; Victorson, David; Choi, Seung W; Heinemann, Allen W

2015-05-01

To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. SCI-QOL Stigma Item Bank A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications.

Development and psychometric evaluation of the Chronic Illness Anticipated Stigma Scale

PubMed Central

Quinn, Diane M.; Kalichman, Seth C.; Park, Crystal L.

2015-01-01

The Chronic Illness Anticipated Stigma Scale (CIASS) was developed to measure anticipated stigma (i.e., expectations of prejudice, stereotyping, and discrimination) among people living with chronic illnesses. The CIASS is a 12-item scale with three subscales differentiating among sources of anticipated stigma, including friends and family members, work colleagues, and healthcare workers. Results support the reliability, validity, and generalizability of the CIASS in two samples of people living with chronic illnesses. The CIASS was correlated with other stigma-related constructs as well as indicators of mental health, physical health, and health behaviors. The CIASS can help researchers gauge the degree to which people living with chronic illnesses anticipate stigma, better understand the processes by which anticipated stigma contributes to the health and behavior of people living with chronic illnesses, and compare the extent to which people living with different types of chronic illnesses anticipate stigma. PMID:22526525

HIV Stigma in Prisons and Jails: Results from a Staff Survey

PubMed Central

Dembo, Richard; Copenhaver, Michael; Hiller, Matthew; Swan, Holly; Garcia, Carmen Albizu; O’Connell, Daniel; Oser, Carrie; Pearson, Frank; Pankow, Jennifer

2015-01-01

With numerous HIV service gaps in prisons and jails, there has been little research on HIV stigma attitudes among correctional staff. Such attitudes may undermine HIV services for inmates at risk of or infected with HIV. This HIV stigma attitudes survey among 218 correctional staff in 32 US facilities (1) provides an overview of staff’s stigma attitudes, (2) reports psychometric analyses of domains in Earnshaw and Chaudoir’s HIV Stigma Framework (HSF), and (3) explores differences in stigma attitudes among different staff types. Overall, correctional and medical staff expressed non stigmatizing attitudes toward people living with HIV/AIDS, but perceived that stigma and discrimination exist in others. Factor analyses revealed a three factor structure capturing two mechanisms of the HSF (prejudice, discrimination). Few factor score differences were found by staff type or setting. Implications for correctional HIV services and future research on HIV stigma attitudes are discussed. PMID:26036464

HIV Stigma in Prisons and Jails: Results from a Staff Survey.

PubMed

Belenko, Steven; Dembo, Richard; Copenhaver, Michael; Hiller, Matthew; Swan, Holly; Albizu Garcia, Carmen; O'Connell, Daniel; Oser, Carrie; Pearson, Frank; Pankow, Jennifer

2016-01-01

With numerous HIV service gaps in prisons and jails, there has been little research on HIV stigma attitudes among correctional staff. Such attitudes may undermine HIV services for inmates at risk of or infected with HIV. This HIV stigma attitudes survey among 218 correctional staff in 32 US facilities (1) provides an overview of staff's stigma attitudes, (2) reports psychometric analyses of domains in Earnshaw and Chaudoir's HIV Stigma Framework (HSF), and (3) explores differences in stigma attitudes among different staff types. Overall, correctional and medical staff expressed non stigmatizing attitudes toward people living with HIV/AIDS, but perceived that stigma and discrimination exist in others. Factor analyses revealed a three factor structure capturing two mechanisms of the HSF (prejudice, discrimination). Few factor score differences were found by staff type or setting. Implications for correctional HIV services and future research on HIV stigma attitudes are discussed.

Weight Stigma Mediates the Association Between BMI and Self-Reported Health

PubMed Central

Hunger, Jeffrey M.; Major, Brenda

2014-01-01

Objective Weight stigma is pervasive in the United States. We tested the hypothesis that stigma may be a mechanism through which obesity negatively affects self-reported health. Two studies examined whether perceived weight-based discrimination and concerns over weight stigma mediated the association between BMI and self-reported psychological health (Study 1) and physical health (Study 2). Method In two online studies, adult community members completed measures of stigma-relevant mediators (perceived weight discrimination, weight stigma concerns) and provided their height and weight. In Study 1 (N = 171) participants also completed measures of psychological health (depression, self-esteem, quality of life), whereas participants in Study 2 (N = 194) also completed a measure of self-reported physical health. Process modeling was used to simultaneously test for mediation through perceived discrimination and stigma concerns independently as well as for serial mediation through both variables. Results Across both studies, we hypothesized and found support for serial mediation such that BMI was indirectly related to poorer self-reported health through its effect on perceived discrimination and concerns about stigma. Additionally, concerns about stigma mediated the association between BMI and health independent of perceived discrimination. Conclusion Weight stigma is an important mediator of the association between BMI and self-reported health. Furthermore, results indicate that concerns about facing stigma in the future mediate the link between perceived past experiences of discrimination and psychological and physical health. PMID:25133837

Self-stigma and schizophrenia: a cross-sectional study

PubMed Central

Vrbova, Kristyna; Prasko, Jan; Holubova, Michaela; Kamaradova, Dana; Ociskova, Marie; Marackova, Marketa; Latalova, Klara; Grambal, Ales; Slepecky, Milos; Zatkova, Marta

2016-01-01

Objective The aim of this study was to investigate the degree of self-stigma in schizophrenia and its association with clinical and demographic factors. Patients and methods A total of 197 outpatients (54.3% females) diagnosed with schizophrenia spectrum disorders (schizophrenia, schizoaffective disorder, delusional disorder) according to International Classification of Diseases – tenth edition participated in the study. The mean age of the patients was 40.10±11.49 years. All individuals completed the Internalized Stigma of Mental Illness (ISMI) scale and a demographic questionnaire. The disorder severity was assessed by both a psychiatrist (the objective version of Clinical Global Impression – severity scale [objCGI-S]) and the patients (the subjective version of Clinical Global Impression – severity scale [subjCGI-S]). Treatment with antipsychotics stabilized the patients. Results The overall level of self-stigma measured by the total score of the ISMI was 63.32±13.59. The total score of the ISMI positively correlated with the severity of the disorder measured by the objCGI-S and subjCGI-S. In addition, self-stigma positively correlated with the treatment duration and the number of psychiatric hospitalizations. The backward stepwise regression was applied to identify the most significant factors connected to self-stigma. The regression analysis identified the following regressors as the most relevant to self-stigma: the number of previous psychiatric hospitalizations, the severity of the disorder rated by a psychiatrist, and the difference between the objective rating and the subjective rating of the severity of the disorder. Conclusion Outpatients with schizophrenia spectrum disorders, who have undergone a higher number of psychiatric hospitalizations, who dispose of a higher severity of the disorder and show a higher discrepancy between their rating of the severity and the psychiatric rating, showed a greater degree of self-stigma. The management of

Anti-Stigma Programs: Stigma in Campus Police Officers

ERIC Educational Resources Information Center

Rafacz, Jennifer D.

2012-01-01

It has been proposed that the most effective way to combat mental illness stigma is to focus on power groups who have a direct impact on the lives of persons with serious mental illness. With the increase of violence and need for mental health services on college campuses, campus police officers are seen as an important power group for persons…

Moving beyond perceptions: internalized stigma in the irritable bowel syndrome.

PubMed

Taft, T H; Riehl, M E; Dowjotas, K L; Keefer, L

2014-07-01

Internalized stigma (IS) is an important construct in the chronic illness literature with implications for several patient reported outcomes. To date, no study exists evaluating IS in patients with the irritable bowel syndrome (IBS). Two hundred and forty three online and clinical participants completed the following questionnaires: the IS scale for mental illness (ISMI; modified for IBS), perceived stigma scale for IBS, NIH-PROMIS Anxiety and Depression Scales, IBS quality of life scale, and the Perceived Health Competence Scale. Demographical and clinical data were also collected. The modified ISMI was reliable and valid in this population. Participants reported both perceived and IS. Alienation was most reported, followed by social withdrawal and discrimination experiences. IS predicted 25-40% of the variance in psychological functioning, quality of life, healthcare utilization, and health competence when controlling for stigma perception and disease variables. IBS patients perceived more stigma from personal relations than healthcare providers. Hispanic participants reported more perceived stigma, indicating there may be cultural differences in IBS-related stigma experience. Symptom severity, disruptiveness, and treatment choices are also implicated in stigma perception and internalization. Patients with IBS report both perceived and IS with alienation most reported. However, IS significantly predicts several patient outcomes when controlling for PS. Cultural and illness traits may influence how stigma is perceived and internalized. Future research is warranted. © 2014 John Wiley & Sons Ltd.

Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women.

PubMed

McCoy, Katryna; Higgins, Melinda; Zuñiga, Julie Ann; Holstad, Marcia McDonnell

Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized controlled trial to improve Antiretroviral treatment (ART) adherence and reduce risky behaviors in HIV-infected women at five clinical sites in a South-eastern city from 2005 to 2008. Stigma was measured using the Perceived Personal Stigma of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) scale. Among participants <50 years old (n=90), age was significantly associated with viral load (rho=-.24, p=.02) and stigma was negatively associated with CD4% (r =-.26, p=.02). For the 30 participants >50 years old, age was not significantly associated with viral load, stigma or CD4%, and there was no significant association between stigma and CD4% (r=.07, p=.70). These findings indicate the need for further study regarding this potential moderating effect and possible interventions to address the susceptibility of younger women to the harmful effects of stigma.

Factors associated with increased felt stigma among individuals with epilepsy.

PubMed

Bautista, Ramon Edmundo D; Shapovalov, Denys; Shoraka, Ali Reza

2015-08-01

The aim of the study is to determine whether certain demographic, clinical, and psychosocial traits are associated with higher levels of felt stigma among persons with epilepsy (PWE) patients followed at a level 4 epilepsy center. We performed a direct survey of 182 consenting patients that included the Epilepsy Stigma Scale. On univariate analysis, higher levels of perceived stigma were associated with age, marital status, race, driving, work status, seizure etiology, Quality of Life in Epilepsy-10 (QOLIE-10) scores, and health literacy. Among coping reactions, the use of denial, behavioral disengagement and venting were also associated with higher degrees of felt stigma. Using multiple linear regression, being single, poorer QOLIE-10 scores, difficulties understanding written information, and the use of behavioral disengagement were independently associated with poorer scores on the Epilepsy Stigma Scale. Our study paints a compelling profile of a PWE who has greater perceived stigma. Programs that increase the level of social support, improve health literacy, and enhance quality of life may also help decrease the amount of felt stigma among PWE. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

“Stigma and Prejudice: One Animal or Two?”

PubMed Central

Phelan, Jo; Link, Bruce G; Dovidio, John F

2014-01-01

In light of increasing cross-communication and possible coalescence of conceptual models of stigma and prejudice, we reviewed 18 key models in order to explore commonalities and possible distinctions between prejudice and stigma. We arrive at two conclusions. First, the two sets of models have much in common (representing “one animal”); most differences are a matter of focus and emphasis. Second, one important distinction is in the type of human characteristics that are the primary focus of models of prejudice (race) and stigma (deviant behavior and identities, and disease and disabilities). This led us to develop a typology of three functions of stigma and prejudice: exploitation and domination (keeping people down); norm enforcement (keeping people in); and disease avoidance (keeping people away). We argue that attention to these functions will enhance our understanding of stigma and prejudice and our ability to reduce them. PMID:18524444

Internalized Stigma among Sexual Minority Adults: Insights from a Social Psychological Perspective

ERIC Educational Resources Information Center

Herek, Gregory M.; Gillis, J. Roy; Cogan, Jeanine C.

2009-01-01

This article describes a social psychological framework for understanding sexual stigma, and it reports data on sexual minority individuals' stigma-related experiences. The framework distinguishes between stigma's manifestations in society's institutions ("heterosexism") and among individuals. The latter include "enacted sexual stigma" (overt…

Social Work Faculty and Mental Illness Stigma

ERIC Educational Resources Information Center

Watson, Amy C.; Fulambarker, Anjali; Kondrat, David C.; Holley, Lynn C.; Kranke, Derrick; Wilkins, Brittany T.; Stromwall, Layne K.; Eack, Shaun M.

2017-01-01

Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice…

Perceived Public Stigma and the Willingness to Seek Counseling: The Mediating Roles of Self-Stigma and Attitudes toward Counseling

ERIC Educational Resources Information Center

Vogel, David L.; Wade, Nathaniel G.; Hackler, Ashley H.

2007-01-01

This study examined the mediating effects of the self-stigma associated with seeking counseling and attitudes toward seeking counseling on the link between perceived public stigma and willingness to seek counseling for psychological and interpersonal concerns. Structural equation modeling of data from 676 undergraduates indicated that the link…

Interventions Targeting Mental Health Self-Stigma: A Review and Comparison

PubMed Central

Yanos, Philip T.; Lucksted, Alicia; Drapalski, Amy L.; Roe, David; Lysaker, Paul

2014-01-01

Objective With growing awareness of the impact of mental illness self-stigma, interest has arisen in the development of interventions to combat it. The present article briefly reviews and compares interventions targeting self-stigma to clarify the similarities and important differences between the interventions. Methods We conducted a narrative review of published literature on interventions targeting self-stigma. Results Six intervention approaches (Healthy Self-Concept, Self-Stigma Reduction Program, Ending Self-Stigma, Narrative Enhancement and Cognitive Therapy, Coming Out Proud, and Anti-Stigma Photo-Voice Intervention) were identified and are discussed, and data is reviewed on format, group-leader backgrounds, languages, number of sessions, primary mechanisms of action, and the current state of data on their efficacy. Conclusions and Implications for Practice We conclude with a discussion of common elements and important distinctions between the interventions and a consideration of which interventions might be best suited to particular populations or settings. PMID:25313530

HIV Interventions to Reduce HIV/AIDS Stigma: A Systematic Review

PubMed Central

Banks, Bahby; Jonas, Dan; Miles, Margaret Shandor; Smith, Giselle Corbie

2011-01-01

We reviewed the literature to determine the effectiveness of HIV-related interventions in reducing HIV/AIDS stigma. Studies selected had randomized controlled trial (RCT), pretest–posttest with a non-randomized control group, or pretest–posttest one group study designs in which HIV-related interventions were being evaluated, and in which HIV/AIDS stigma was one of the outcomes being measured. A checklist was used to extract data from accepted studies, assess their internal validity, and overall quality. Data were extracted from 19 studies, and 14 of these studies demonstrated effectiveness in reducing HIV/ AIDS stigma. Only 2 of these 14 effective studies were considered good studies, based on quality, the extent to which the intervention focused on reducing HIV/AIDS stigma, and the statistics reported to demonstrate effectiveness. Future studies to reduce HIV/AIDS stigma could improve by designing interventions that pay greater attention to internal validity, use validated HIV/AIDS stigma instruments, and achieve both statistical and public health significance. PMID:21088989

Paved with good intentions: Paradoxical eating responses to weight stigma.

PubMed

Nolan, Laurence J; Eshleman, Amy

2016-07-01

Because body weight is largely seen as controllable, weight stigma-the social devaluation of those who are overweight-is not subject to the social norms that condemn open expression of racism and sexism. Indeed, rejection of peers based on perceptions of excess weight is normative. Since weight stigma is internalized, popular views (and often the views of physicians) have suggested that increasing the salience of weight stigma might produce a reduction in overeating and/or an increase in physical activity. However, that perspective is not rooted in scientific evidence. Recent randomized controlled designs demonstrate that stigma may promote overeating. Correlational evidence suggests that self-reported stigma experience is associated with risk for binge eating and decreased interest in physical exercise and dieting, for children and adults. In addition to reviewing these research studies, this paper examines the potential for intersectionality of stigma across multiple social identities and considers alternatives to stigmatizing weight loss interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

HIV interventions to reduce HIV/AIDS stigma: a systematic review.

PubMed

Sengupta, Sohini; Banks, Bahby; Jonas, Dan; Miles, Margaret Shandor; Smith, Giselle Corbie

2011-08-01

We reviewed the literature to determine the effectiveness of HIV-related interventions in reducing HIV/AIDS stigma. Studies selected had randomized controlled trial (RCT), pretest-posttest with a non-randomized control group, or pretest-posttest one group study designs in which HIV-related interventions were being evaluated, and in which HIV/AIDS stigma was one of the outcomes being measured. A checklist was used to extract data from accepted studies, assess their internal validity, and overall quality. Data were extracted from 19 studies, and 14 of these studies demonstrated effectiveness in reducing HIV/AIDS stigma. Only 2 of these 14 effective studies were considered good studies, based on quality, the extent to which the intervention focused on reducing HIV/AIDS stigma, and the statistics reported to demonstrate effectiveness. Future studies to reduce HIV/AIDS stigma could improve by designing interventions that pay greater attention to internal validity, use validated HIV/AIDS stigma instruments, and achieve both statistical and public health significance.

Experience of social stigma by people with schizophrenia in Hong Kong.

PubMed

Lee, Sing; Lee, Margaret T Y; Chiu, Marcus Y L; Kleinman, Arthur

2005-02-01

Research on stigma often focuses on general public attitudes and overlooks patients' subjective experiences of everyday stigma arising from significant others. To document and compare the interpersonal experiences of stigma in patients with schizophrenia and patients with diabetes mellitus in Hong Kong. Four focus groups were conducted to generate a self-report questionnaire. Data were collected from out-patients with schizophrenia (n=320) and diabetes (n=160). Significantly more patients with schizophrenia (>40%) than diabetes (average 15%) experienced stigma from family members, partners, friends and colleagues. Over 50% anticipated stigma and about 55% concealed their illness. Dysphoria occurred in over half. Interpersonal (especially intrafamilial) stigma was pervasive, hard to avoid and devastating to patients with schizophrenia. Family support had to be realised rather than assumed, despite the emphasis on relationship bonds in Chinese society. Programmes that build the family as a rehabilitative resource should start early to reduce the development and adverse impacts of stigma.

Addressing Ebola-related stigma: lessons learned from HIV/AIDS.

PubMed

Davtyan, Mariam; Brown, Brandon; Folayan, Morenike Oluwatoyin

2014-01-01

HIV/AIDS and Ebola Virus Disease (EVD) are contemporary epidemics associated with significant social stigma in which communities affected suffer from social rejection, violence, and diminished quality of life. To compare and contrast stigma related to HIV/AIDS and EVD, and strategically think how lessons learned from HIV stigma can be applied to the current EVD epidemic. To identify relevant articles about HIV/AIDS and EVD-related stigma, we conducted an extensive literature review using multiple search engines. PubMed was used to search for relevant peer-reviewed journal articles and Google for online sources. We also consulted the websites of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health to retrieve up-to-date information about EVD and HIV/AIDS. Many stigmatizing attitudes and behaviors directed towards those with EVD are strikingly similar to those with HIV/AIDS but there are significant differences worthy of discussion. Both diseases are life-threatening and there is no medical cure. Additionally misinformation about affected groups and modes of transmission runs rampant. Unlike in persons with EVD, historically criminalized and marginalized populations carry a disproportionately higher risk for HIV infection. Moreover, mortality due to EVD occurs within a shorter time span as compared to HIV/AIDS. Stigma disrupts quality of life, whether it is associated with HIV infection or EVD. When addressing EVD, we must think beyond the immediate clinical therapeutic response, to possible HIV implications of serum treatment. There are emerging social concerns of stigma associated with EVD infection and double stigma associated with EVD and HIV infection. Drawing upon lessons learned from HIV, we must work to empower and mobilize prominent members of the community, those who recovered from the disease, and organizations working at the grassroots level to disseminate clear and accurate

Stigma Reduction Among African American Women with HIV: UNITY Health Study.

PubMed

Rao, Deepa; Kemp, Christopher G; Huh, David; Nevin, Paul E; Turan, Janet; Cohn, Susan E; Simoni, Jane M; Andrasik, Michele; Molina, Yamile; Mugavero, Michael J; French, Audrey L

2018-03-08

African American women encounter disproportionately high rates of HIVrelated morbidity and mortality which is partially mediated through stigma and its effect on HIV treatment adherence. To assess the effect of the UNITY peer support workshop on HIV-related stigma among African American women living with HIV, compared to a time and attention control group. African American women living with HIV were randomized to the UNITY workshop or a breast cancer education control group. Interventions took place in HIV clinics in Chicago, IL and Birmingham, AL. Participants self-reported HIV-related stigma and social support at baseline, post-workshop, and 4 follow-up visits over 12 months. 239 participants (UNITY n=124; breast cancer education n=115) were assessed over one year. Both arms experienced decreases in mean stigma scores over time. Our model estimated that allocation to UNITY was not associated with a significant difference in stigma points over time. Post-hoc analysis suggested that preceding increases in perceived social support are associated with decreased HIVrelated stigma in this population. Although UNITY did not significantly reduce HIV-related stigma in this population, our findings suggest that social support may be key to HIV-related stigma reduction.

THE EFFECT OF STIGMA ON CRIMINAL OFFENDERS’ FUNCTIONING: A LONGITUDINAL MEDIATIONAL MODEL*

PubMed Central

Moore, Kelly E.; Stuewig, Jeffrey B.; Tangney, June P.

2015-01-01

Research has rarely considered criminal offenders’ psychological responses to stigma, but these responses may significantly influence behavior after release from jail/prison. Jail inmates’ perceived and anticipated stigma was assessed prior to release from jail/prison (N = 163), and outcomes were assessed one year post-release (N = 371). We hypothesized that perceived stigma would predict poor adjustment in several domains (i.e. recidivism, substance dependence, mental health symptoms, community adjustment) through anticipated stigma. Results showed that perceived stigma predicted worse community adjustment through anticipated stigma, and this varied by race. Results are explored from an interdisciplinary perspective. PMID:26973364

Stigma Experienced by Parkinson's Disease Patients: A Descriptive Review of Qualitative Studies.

PubMed

Maffoni, Marina; Giardini, Anna; Pierobon, Antonia; Ferrazzoli, Davide; Frazzitta, Giuseppe

2017-01-01

Parkinson's disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient's subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver's stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients' and caregiver's point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view.

Stigma Experienced by Parkinson's Disease Patients: A Descriptive Review of Qualitative Studies

PubMed Central

Maffoni, Marina; Pierobon, Antonia; Ferrazzoli, Davide

2017-01-01

Parkinson's disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient's subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver's stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients' and caregiver's point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view. PMID:28243481

Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes

PubMed Central

Zimmerman, Sheryl; Dobbs, Debra; Roth, Erin G.; Goldman, Susan; Peeples, Amanda D.; Wallace, Brandy

2016-01-01

Purpose of the Study: To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Design and Methods: Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, families, and staff members. Qualitative analyses identified the themes that resulted when examining text describing either structures of care or processes of care in relation to 7 codes associated with stigma. Results: Four themes related to structures of care and stigma were identified, including the physical environment, case mix, staff training, and multilevel settings; five themes related to processes of care and stigma, including dining, independence, respect, privacy, and care provision. For each theme, examples were identified illustrating how structures and processes of care can potentially promote or protect against stigma. Implications: In no instance were examples or themes identified that suggested the staff intentionally promoted stigma; on the other hand, there was indication that some structures and processes were intentionally in place to protect against stigma. Perhaps the most important theme is the stigma related to multilevel settings, as it has the potential to reduce individuals’ likelihood to seek and accept necessary care. Results suggest specific recommendations to modify care and reduce stigma. PMID:24928555

Stigma in Ethiopia: association with depressive symptoms in people with HIV.

PubMed

Endeshaw, Meheret; Walson, Judd; Rawlins, Sarah; Dessie, Abere; Alemu, Shitaye; Andrews, Nancy; Rao, Deepa

2014-01-01

Rates of depression among people living with HIV can be as high as 50%. In many settings, HIV-related stigma has been associated with depressive symptoms which may lead to poor engagement in care and ultimately, poorer health outcomes. Stigma is a major issue in Ethiopia but data examining the relationship between stigma and depression in Ethiopia are lacking. We performed a mixed-methods cross-sectional study to examine the relationship between stigma of HIV/AIDS and depressive symptoms in Gondar, Ethiopia. We interviewed patients who presented for routine HIV care at Gondar University Hospital during the study period, examining depressive symptoms and HIV/AIDS-related stigma using standardized measures. Multiple-regression was used to assess the relationship between depressive symptoms, stigma, and gender. Of 55 patients included in this analysis, 63.6% were female and most participants had limited formal education (69%, less than 12th grade education). The majority reported experiencing both stigma (78%) and depressive symptoms (60%) ranging in severity from mild to moderately severe. Higher levels of HIV-related stigma were significantly associated with higher levels of depressive symptoms (β = 0.464, p ≤ 0.001). Although gender was associated with stigma, it was not associated with depressive symptoms (β = -0.027, p > 0.05). Results suggest the importance of psychosocial issues in the lives of people with HIV in Ethiopia.

Perception and coping with stigma of mental illness: Arab families' perspectives.

PubMed

Dalky, Heyam F

2012-07-01

Family stigma is well documented in the research literature; however, it has only been recently that efforts have been undertaken to discuss the perception of stigma as reported by Arab families of relatives with mental illness. This clinical paper aims to identify families' perception of stigma related to mental illness, and to compare Arab families' approaches with various aspects of caring from different countries. Further, this paper discusses, in-depth, specific areas related to families' perceptions of stigma: What impacts does stigma perception have on those families and on their relatives' care outcomes and what are coping strategies are used to handle stigma and its impacts in such countries? This paper emphasizes that chronic mental illness contributes the most to families' perception of stigma. In this study, Arab families perceived the experience of caring for a family member with a mental illness with fear, loss, embarrassment, and disgrace of family reputations. Further, secrecy, isolation, despair, and helplessness were reported the most among different family groups in Jordan and Morocco. This paper reminds us that cultural norms and beliefs shape family members' perception of coping and their ability to manage caring for relatives with mental illnesses. Thus, more studies are needed concerning coping and management strategies that are culturally relevant. This could eventually guide the establishment of stigma reduction initiatives and expand understanding of stigma from different cultural perspectives.

Social stigma towards neglected tropical diseases: a systematic review.

PubMed

Hofstraat, Karlijn; van Brakel, Wim H

2016-03-01

People affected by neglected tropical diseases (NTDs) are frequently the target of social stigmatization. To date not much attention has been given to stigma in relation to NTDs. The objective of this review is to identify the extent of social stigma and the similarities and differences in the causes, manifestations, impact of stigma and interventions used between the NTDs. A systematic review was conducted in Pubmed, ScienceDirect, PsycINFO and Web of Knowledge. The search encompassed 17 NTDs, including podoconiosis, but not leprosy as this NTD has recently been reviewed. However, leprosy was included in the discussion. The 52 selected articles provided evidence on stigma related to lymphatic filariasis (LF), podoconiosis, Buruli ulcer, onchocerciasis, schistosomiasis, leishmaniasis, Chagas disease, trachoma, soil-transmitted helminthiasis (STH) and human African trypanosomiasis. The similarities predominated in stigma related to the various NTDs; only minimal differences in stigma reasons and measures were found. These similarities suggest that joint approaches to reduce stigmatization may be feasible. Lessons from leprosy and other stigmatized health conditions can be used to plan such joint approaches. Further research will be necessary to study the efficacy of joint interventions and to investigate stigma related to NTDs for which no evidence is available yet. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Stigma, Social Structure, and the Biomedical Framework: Exploring the Stigma Experiences of Inpatient Service Users in Two Belgian Psychiatric Hospitals.

PubMed

Sercu, Charlotte; Bracke, Piet

2017-07-01

The study discusses the stigma experiences of service users in mental health care, within the debate on the role of the biomedical framework for mental health care and power relations in society. Interview data of inpatient users ( n = 42) and care providers ( n = 43) from two Belgian psychiatric hospitals were analyzed using a constructivist grounded theory approach: Findings offer insight into how stigma experiences are affected by social structure. Stigma seemed to be related to the relation between care providers and service users their social position. The concept "mental health literacy" is used to frame this finding. In paying attention to the specific cultural and normative context, which influences the relationship between mental health literacy and stigma, it is further possible to cast some light on the meaning of the biomedical model for the construction and maintenance of power relations in mental health care and broader society.

Overcoming diabetes-related stigma in Iran: A participatory action research.

PubMed

Doosti-Irani, Mehri; Abdoli, Samereh; Parvizy, Soroor; Fatemi, Naimeh Seyed

2017-08-01

The study aimed to overcome diabetes-related stigma in individuals living with type 1 Diabetes Mellitus (T1DM) in Iran. The study proposed that if individuals with T1DM and the community work together to develop and implement an anti-stigma program, diabetes-related stigma in individuals with T1DM can be reduced. This study was conducted as a participatory action research study based on Kemmis and McTaggert's (2000) Model to design and implement an anti-stigma program for T1DM. Participants were selected among individuals with T1DM, their family members, health care providers, and residents without diabetes in Isfahan, Iran. Data collection was conducted using interviews, focus groups, emails, and text messages. Content analysis was used to analyze the data to develop anti-stigma interventions. Interventions were prioritized based on the Suitability, Feasibility and Flexibility (SFF) Matrix. Anti-stigma interventions were implemented in different levels in Isfahan, Iran, from 2011 to 2014. The effect of the program was evaluated based on interviews, feedback, and focus groups at the individual level. However, interventions were implemented in different levels including community, organization, family, and individual. Participants with T1DM experienced significant empowerment during the project to overcome diabetes-related stigma. The three main themes indicating this feeling of empowerment are "from doubt to trust", "from shadow to light", and "from me to us". Participatory action research can be an effective way to reduce diabetes-related stigma in individuals living with T1DM. It integrates the voices of the marginalized group reducing stigma and discrimination against diabetes. Copyright © 2017. Published by Elsevier Inc.

Empirical Studies of Self-Stigma Reduction Strategies: A Critical Review of the Literature.

PubMed

Mittal, Dinesh; Sullivan, Greer; Chekuri, Lakshminarayana; Allee, Elise; Corrigan, Patrick W

2012-10-01

The purpose of this article was to comprehensively review published literature about strategies to reduce self-stigma among people with mental illness. Recommendations and implications for research also are discussed. The electronic databases of Ovid, PubMed, and PsycINFO were searched for peer-reviewed articles published between January 2000 and August 2011 by using the key words “self-stigma,” “internalized stigma,” “perceived stigma,” and “stigma intervention.” The search was further narrowed to studies that described a detailed intervention and that used self-stigma as a primary or secondary outcome, tested the intervention among individuals with a psychiatric illness, and analyzed data quantitatively with acceptable statistical tools. Fourteen articles met inclusion criteria, and eight reported significant improvement in self-stigma outcomes. Participants predominantly had schizophrenia and related disorders or depression. Six self-stigma reduction strategies were identified. Psychoeducation was the most frequently tested intervention. Self-stigma definitions, measurements, and conceptual frameworks varied considerably across these studies. Several studies lacked a theoretical framework for their intervention. Six different scales were used to measure self-stigma. Two prominent approaches for self-stigma reduction emerged from our review: one, interventions that attempt to alter the stigmatizing beliefs and attitudes of the individual; and two, interventions that enhance skills for coping with self-stigma through improvements in self-esteem, empowerment, and help-seeking behavior. The second approach seems to have gained traction among stigma experts. Targeting high-risk groups to preempt self-stigma appears to be a promising area for future research.

Geographic distribution of HIV stigma among women of childbearing age in rural Kenya

PubMed Central

Akullian, Adam; Kohler, Pamela; Kinuthia, John; Laserson, Kayla; Mills, Lisa A.; Okanda, John; Olilo, George; Ombok, Maurice; Odhiambo, Frank; Rao, Deepa; Wakefield, Jonathan; John-Stewart, Grace

2015-01-01

Objective(s) HIV stigma is considered to be a major driver of the HIV/AIDS pandemic, yet there is a limited understanding of its occurrence. We describe the geographic patterns of two forms of HIV stigma in a cross-sectional sample of women of childbearing age from western Kenya: internalized stigma (associated with shame) and externalized stigma (associated with blame). Design Geographic studies of HIV stigma provide a first step in generating hypotheses regarding potential community-level causes of stigma and may lead to more effective community-level interventions. Methods Spatial regression using generalized additive models and point pattern analyses using K-functions were used to assess the spatial scale(s) at which each form of HIV stigma clusters, and to assess whether the spatial clustering of each stigma indicator was present after adjustment for individual-level characteristics. Results There was evidence that externalized stigma (blame) was geographically heterogeneous across the study area, even after controlling for individual-level factors (P=0.01). In contrast, there was less evidence (P=0.70) of spatial trend or clustering of internalized stigma (shame). Conclusion Our results may point to differences in the underlying social processes motivating each form of HIV stigma. Externalized stigma may be driven more by cultural beliefs disseminated within communities, whereas internalized stigma may be the result of individual-level characteristics outside the domain of community influence. These data may inform community-level interventions to decrease HIV-related stigma, and thus impact the HIV epidemic. PMID:24835356

Genetic Causal Attribution of Epilepsy and its Implications for Felt Stigma

PubMed Central

Sabatello, Maya; Phelan, Jo C.; Hesdorffer, Dale C.; Shostak, Sara; Goldsmith, Jeff; Sorge, Shawn T.; Winawer, Melodie R.; Chung, Wendy K.; Ottman, Ruth

2015-01-01

Summary Objective Research in other disorders suggests that genetic causal attribution of epilepsy might be associated with increased stigma. We investigated this hypothesis in a unique sample of families containing multiple individuals with epilepsy. Methods 181 people with epilepsy and 178 biological relatives without epilepsy completed a self-administered survey. In people with epilepsy, felt stigma was assessed through the Epilepsy Stigma Scale (ESS), scored 1 to 7 with higher scores indicating more stigma and >4 indicating some felt stigma. Felt stigma related to having epilepsy in the family was assessed through the Family Epilepsy Stigma Scale (FESS), created by replacing “epilepsy” with “epilepsy in my family” in each ESS item. Genetic attribution was assessed through participants’ perceptions of the (1) role of genetics in causing epilepsy in the family, (2) chance they had an epilepsy-related mutation, and (3) (in people with epilepsy) influence of genetics in causing their epilepsy. Results Among people with epilepsy, 22% met criteria for felt stigma (ESS score >4). Scores were increased among individuals who were aged ≥60 years, were unemployed, reported epilepsy-related discrimination, or had seizures within the last year or >100 seizures in their lifetime. Adjusting for other variables, ESS scores in people with epilepsy were significantly higher among those who perceived genetics played a “medium” or “big” role in causing epilepsy in the family than in others (3.4 vs. 2.7, p=0.025). Only 4% of relatives without epilepsy had felt stigma. Scores in relatives were unrelated to genetic attribution. Significance In these unusual families, predictors of felt stigma in individuals with epilepsy are similar to those in other studies, and stigma levels are low in relatives without epilepsy. Felt stigma may be increased in people with epilepsy who believe epilepsy in the family has a genetic cause, emphasizing the need for sensitive

Stigma and functioning in patients with bipolar disorder.

PubMed

Vázquez, G H; Kapczinski, F; Magalhaes, P V; Córdoba, R; Lopez Jaramillo, C; Rosa, A R; Sanchez de Carmona, M; Tohen, M

2011-04-01

The aim of this study was to investigate the impact of self-rated stigma and functioning in patients with bipolar disorder in Latin-America. Two-hundred and forty-one participants with bipolar disorder were recruited from three Latin American countries (Argentina, Brazil, and Colombia). Functional impairment was assessed with the Functioning Assessment Short Test (FAST) and experiences with and impact of perceived stigma was evaluated using the Inventory of Stigmatizing Experiences (ISE). Higher scores of self-perceived stigma were correlated with lower scores of functioning. After multiple regression analysis, being on disability benefit, current mood symptoms and functioning were associated with self-perceived stigma. This is the first study to demonstrate an association between stigma and poor functioning in bipolar disorder. Possible implications of such findings for practitioners are discussed. The main limitation of this study is that the Inventory of Stigmatizing Experiences has not yet been validated in a population of bipolar patients in our countries. The sample size and heterogeneous clinical subjects from different countries and cultures limit the generalization of the present findings. Copyright © 2010 Elsevier B.V. All rights reserved.

Stigma and psychiatric morbidity among mothers of children with epilepsy in Zambia

PubMed Central

Elafros, Melissa A.; Sakubita-Simasiku, Claire; Atadzhanov, Masharip; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

2013-01-01

Background Epilepsy-associated stigma contributes substantially to the social, medical, and economic burden of disease for people with epilepsy (PWE), but little is known about its impact on caregivers of PWE. Methods To better understand stigma experienced by caregivers of PWE, factors that influence caregiver stigma, and the effect of stigma on a caregiver's psychologic well being, we interviewed 100 caregivers of children with epilepsy in Zambia. Questions assessed maternal knowledge, attitudes, and practices related to epilepsy, maternal stigma, mother's proxy report of child stigma, and maternal psychiatric morbidity. Results Of 100 mothers, 39 (39%) indicated that their child was stigmatized because of his or her epilepsy. Maternal proxy report of child stigma was highly correlated with maternal stigma (OR: 5.4, p=0.04), seizure frequency (p=0.03) and seizure severity (p=0.01). One in five of 100 mothers (20%) reported feeling stigmatized because of their child's epilepsy. Higher maternal stigma was associated with lower familial and community support (ORs: 65.2 and 34.7, respectively; both p<0.0001) as well as higher psychiatric morbidity (OR: 1.2; p=0.002). Formal education and epilepsy knowledge were associated with decreased maternal stigma (ORs: 0.8 and 0.7, respectively; both p<0.001). Conclusions One in five mothers of PWE feel stigmatized because of their child's epilepsy. As maternal stigma is associated with psychiatric morbidity, educating caregivers about epilepsy and screening for anxiety and depression are warranted. PMID:24214528

Dentistry and HIV/AIDS related stigma.

PubMed

Elizondo, Jesus Eduardo; Treviño, Ana Cecilia; Violant, Deborah

2015-01-01

To analyze HIV/AIDS positive individual's perception and attitudes regarding dental services. One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo León, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis. Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients' HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%). We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment.

Dentistry and HIV/AIDS related stigma

PubMed Central

Elizondo, Jesus Eduardo; Treviño, Ana Cecilia; Violant, Deborah

2015-01-01

OBJECTIVE To analyze HIV/AIDS positive individual’s perception and attitudes regarding dental services. METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo León, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis. RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients’ HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%). CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment. PMID:26538100

Stigma and the perpetuation of obesity.

PubMed

Brewis, Alexandra A

2014-10-01

Even as obesity rates reach new highs, the social stigmatization of obesity seems to be strengthening and globalizing. This review identifies at least four mechanisms by which a pervasive environment of fat stigma could reinforce high body weights or promote weight gain, ultimately driving population-level obesity. These are direct effects through behavior change because of feeling judged, and indirect effects of social network changes based on stigmatizing actions and decisions by others, psychosocial stress from feeling stigmatized, and the structural effects of discrimination. Importantly, women and children appear especially vulnerable to these mechanisms. The broader model provides an improved basis to investigate the role of stigma in driving the etiology of obesity, and explicates how individual, interpersonal, and structural dimensions of stigma are connected to variation in health outcomes, including across generations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mental illness, stigma, and the media.

PubMed

Benbow, Alastair

2007-01-01

Society is ingrained with prejudice toward mental illness, and sufferers are often widely perceived to be dangerous or unpredictable. Reinforcement of these popular myths through the media can perpetuate the stigma surrounding mental illness, precipitating shame, self-blame, and secrecy, all of which discourage affected individuals from seeking treatment. Efforts aimed at countering stigma in mental illness are faced with the challenge of centuries of discrimination and must, therefore, replace existing stereotypes with coverage of positive outcomes, as a first step in achieving the daunting task of overcoming these negative stereotypes. Long-term anti-stigma campaigns that encompass human-rights-based, normalization, and educational approaches are needed. The involvement of the media is essential for success, but, in order for the media to be used effectively, its motivations and limitations must first be recognized and understood.

Lessons on Stigma: Teaching about HIV/AIDS

ERIC Educational Resources Information Center

Lichtenstein, Bronwen; DeCoster, Jamie

2014-01-01

Teaching about the sociology of HIV/AIDS involves teaching about the causes and effects of stigma. We describe a Sociology of HIV/AIDS course at the University of Alabama in which stigma reduction was assessed as a primary objective. The syllabus involved theory-based instruction, class visits, service learning, and student research on community…

Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form

PubMed Central

Kisala, Pamela A.; Tulsky, David S.; Pace, Natalie; Victorson, David; Choi, Seung W.; Heinemann, Allen W.

2015-01-01

Objective To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). Design Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. Setting Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants Adults with traumatic SCI. Main Outcome Measures SCI-QOL Stigma Item Bank Results A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. Conclusions The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications. PMID:26010973

Assessing Bisexual Stigma and Mental Health Status: A Brief Report

PubMed Central

Bostwick, Wendy

2013-01-01

Bisexual women often report higher rates of depression and mental health problems than their heterosexual and lesbian counterparts. These disparities likely occur, in part, as a result of the unique stigma that bisexual women face and experience. Such stigma can in turn operate as a stressor, thereby contributing to poor mental health status. The current pilot study tested a new measure of bisexual stigma and its association with mental health. Results suggest a moderate positive correlation between the two, and point to areas for future consideration when measuring bisexual stigma. PMID:24683314

Mental illness stigma in the Israeli context: deliberations and suggestions.

PubMed

Tal, Amir; Roe, David; Corrigan, Patrick W

2007-11-01

In this paper we deliberate mental illness stigma in the Israeli context and suggest ways to reduce it, emphasizing the community's role in the rehabilitation of persons with mental illness. A literature review of Israeli and international literature of mental illness stigma. Community mental health, in addition to its traditional focus on developing community-based services, should focus also on community-based interventions such as the delivery of anti-stigma interventions. Providing individualized rehabilitation services in the community while addressing stigma-induced social barriers may create a better recovery ground for Israelis with mental illness.

Pathways between stigma and suicidal ideation among people at risk of psychosis.

PubMed

Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

2016-04-01

Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Cultural Variation in Implicit Mental Illness Stigma.

PubMed

Cheon, Bobby K; Chiao, Joan Y

2012-10-01

Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.

Stigma as a Fundamental Cause of Population Health Inequalities

PubMed Central

Phelan, Jo C.

2013-01-01

Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health. PMID:23488505

Attitudes about sexual disclosure and perceptions of stigma and shame

PubMed Central

Cunningham, S; Tschann, J; Gurvey, J; Fortenberry, J; Ellen, J

2002-01-01

Methods: A household sample of 142 sexually active African-American youths, 13–19 years old, was questioned about STD related stigma (alpha = 0.89), STD related shame (alpha = 0.90), and perceptions about disclosure of sexual behaviours to a doctor or nurse (alpha = 0.81). Results: Among females, stigma was associated with increased anticipation of negative reactions to disclosure of sexual behaviours to a doctor or nurse (odds ratio (OR) = 0.319; 95% confidence interval (CI) =0.12 to 0.85) while shame was not. Stigma was also independently associated with STD related care seeking in the past year (OR = 0.296; 95% CI = 0.09 to 0.94) while shame was not. There was no association between stigma and shame with perceptions about disclosure or past care seeking in males. Perceived outcomes of disclosing sexual behaviours did not moderate the association of stigma, shame, and past STD related care seeking. Conclusions: Stigma about STDs may influence how female adolescents perceive reactions to disclosure of their sexual behaviour to healthcare providers. It may also be an important factor in their decision seek to STD related care. Perceptions about disclosure of sexual behaviour to a doctor or nurse do not change the relation of stigma or shame to past STD related care seeking. PMID:12407233

Self-clarity and different clusters of insight and self-stigma in mental illness.

PubMed

Hasson-Ohayon, Ilanit; Mashiach-Eizenberg, Michal; Lysaker, Paul H; Roe, David

2016-06-30

The current study explored the self-experience of persons with Serious Mental Illness (SMI) by investigating the associations between different insight and self-stigma clusters, self-clarity, hope, recovery, and functioning. One hundred seven persons diagnosed with a SMI were administered six scales: self-concept clarity, self-stigma, insight into the illness, hope, recovery, and functioning. Correlations and cluster analyses were performed. Insight, as measured by a self-report scale was not related to any other variable. Self-stigma was negatively associated with self-clarity, hope, recovery and functioning. Three clusters emerged: moderate stigma/high insight (n=31), high stigma/moderate insight (n=28), and low stigma/low insight (n=42). The group with low stigma and low insight had higher mean levels of self-clarity and hope than the other two groups. There were no significant differences between cluster 1 (moderate stigma/high insight) and cluster 2 (high stigma/moderate insight) in all the variables beside self-clarity. The group with moderate stigma and high insight had significantly higher mean levels of self-clarity than the group with high stigma and moderate insight. Results reveal that when people diagnosed with SMI do not have high levels of self-stigma they often report a positive and clear sense of self accompanied with hope, regardless of having low insight. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stigma resistance is positively associated with psychiatric and psychosocial outcomes: A meta-analysis.

PubMed

Firmin, Ruth L; Luther, Lauren; Lysaker, Paul H; Minor, Kyle S; Salyers, Michelle P

2016-08-01

To better understand how stigma resistance impacts functioning-related domains, we examined mean effect sizes between stigma resistance and: 1) symptoms (overall, positive, negative, and mood symptoms); 2) self-stigma; 3) self-efficacy; 4) quality of life; 5) recovery; 6) hope; 7) insight, and 8) overall outcomes (the average effect size across the constructs examined in each study). The mean effect size between stigma resistance and overall outcomes was significant and positive (r=0.46, p<0.001, k=48). A large, negative effect size was found between stigma resistance and self-stigma (r=-0.57, p<0.001, k=40). Large, positive effect sizes were found with self-efficacy (r=0.60, p<0.001, k=25), quality of life (r=0.51, p<0.001, k=17), hope (r=0.54, p<0.001, k=8), and recovery (r=0.60, p<0.001, k=7). Stigma resistance had a significant medium and small relationship with insight and symptoms, respectively. Race significantly moderated overall outcomes, self-stigma, mood symptoms, functioning, and hope associations. Education significantly moderated symptoms, functioning, and mood symptoms associations, and age significantly moderated self-stigma and negative symptom associations. Stigma resistance may be a key requirement for recovery. Individual characteristics influence resisting stigma and future work should prioritize cultural factors surrounding stigma resistance. Copyright © 2016 Elsevier B.V. All rights reserved.

Reducing self-stigma by coming out proud.

PubMed

Corrigan, Patrick W; Kosyluk, Kristin A; Rüsch, Nicolas

2013-05-01

Self-stigma has a pernicious effect on the lives of people with mental illness. Although a medical perspective might discourage patients from identifying with their illness, public disclosure may promote empowerment and reduce self-stigma. We reviewed the extensive research that supports this assertion and assessed a program that might diminish stigma's effect by helping some people to disclose to colleagues, neighbors, and others their experiences with mental illness, treatment, and recovery. The program encompasses weighing the costs and benefits of disclosure in deciding whether to come out, considering different strategies for coming out, and obtaining peer support through the disclosure process. This type of program may also pose challenges for public health research.

Reducing stigma in reproductive health.

PubMed

Cook, Rebecca J; Dickens, Bernard M

2014-04-01

Stigmatization marks individuals for disgrace, shame, and even disgust-spoiling or tarnishing their social identities. It can be imposed accidentally by thoughtlessness or insensitivity; incidentally to another purpose; or deliberately to deter or punish conduct considered harmful to actors themselves, others, society, or moral values. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Unmarried motherhood has a long history of shame, projected onto the "illegitimate" (bastard) child. The stigma of contracting sexually transmitted infections has been reinvigorated with HIV infection. Gynecologists and their professional associations, ethically committed to uphold human dignity and equality, especially for vulnerable women for whom they care, should be active to guard against, counteract, and relieve stigmatization of their patients and of related service providers. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Public stigma towards mental illness in the Greek culture.

PubMed

Tzouvara, V; Papadopoulos, C

2014-12-01

Mental illness stigma negatively affects the lives of individuals with mental health disorders. Studies have indicated that the type and degree of stigma significantly varies across cultures. This study aimed to add to this body of knowledge by examining the prevalence and the type of mental illness stigma among individuals who identified themselves as Greek. It also examined the influence of a range of potential within-culture stigma moderating factors, including levels of previous experience with mental illness and mental illness knowledge. A cross-sectional quantitative design was employed, and 111 participants living in England and Greece were sampled through the snowball sampling technique. Stigma prevalence was measured using the 'Community Attitudes to Mental Illness' questionnaire. The findings revealed that participants showed a high degree of sympathy for people with mental illness but also considered them to be inferior and of a lower social class, and needing strict societal control. Higher stigma was significantly associated with being educated in England (instead of Greece), higher religiosity, lower knowledge levels and lower levels personal experience of mental illness. Targeted antistigma campaigns specifically tailored for the Greek culture are required in order to help reduce stigmatizing attitudes. © 2014 John Wiley & Sons Ltd.

The delaying effect of stigma on mental health help-seeking in Sri Lanka.

PubMed

Fernando, Sunera M; Deane, Frank P; McLeod, Hamish J

2017-03-01

Mental health stigma has been associated with delays in seeking treatment. To describe perceived stigma experienced by patients and carers in Sri Lanka and to determine the effects of stigma on help-seeking delay. Survey of outpatients and family carers (n = 118 dyads) attending two psychiatric hospitals in Sri Lanka, using the Disclosure and Discrimination subscales of the Stigma Scale. Stigma was positively related to help-seeking delay for carers but not patients. Public stigma experienced by carers accounted for 23% of the variance in help-seeking delay. Reducing stigma may reduce help-seeking delays during the course of treatment. © 2016 John Wiley & Sons Australia, Ltd.

Association Between Internalized HIV-Related Stigma and HIV Care Visit Adherence.

PubMed

Rice, Whitney S; Crockett, Kaylee B; Mugavero, Michael J; Raper, James L; Atkins, Ghislaine C; Turan, Bulent

2017-12-15

Internalized HIV-related stigma acts as a barrier to antiretroviral therapy (ART) adherence, but its effects on other HIV care continuum outcomes are unclear. Among 196 HIV clinic patients in Birmingham, AL, we assessed internalized HIV-related stigma and depressive symptom severity using validated multi-item scales and assessed ART adherence using a validated single-item measure. HIV visit adherence (attended out of total scheduled visits) was calculated using data from clinic records. Using covariate-adjusted regression analysis, we investigated the association between internalized stigma and visit adherence. Using path analytic methods with bootstrapping, we tested the mediating role of depressive symptoms in the association between internalized stigma and visit adherence and the mediating role of visit adherence in the association between internalized stigma and ART adherence. Higher internalized stigma was associated with lower visit adherence (B = -0.04, P = 0.04). Black (versus white) race and depressive symptoms were other significant predictors within this model. Mediation analysis yielded no indirect effect through depression in the association between internalized stigma and visit adherence (B = -0.18, SE = 0.11, 95% confidence interval: -0.44 to -0.02) in the whole sample. Supplemental mediated moderation analyses revealed gender-specific effects. Additionally, the effect of internalized stigma on suboptimal ART adherence was mediated by lower visit adherence (B = -0.18, SE = 0.11, 95% confidence interval: -0.44 to -0.02). Results highlight the importance of internalized HIV stigma to multiple and sequential HIV care continuum outcomes. Also, findings suggest multiple intervention targets, including addressing internalized stigma directly, reducing depressive symptoms, and promoting consistent engagement in care.

Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes.

PubMed

Zimmerman, Sheryl; Dobbs, Debra; Roth, Erin G; Goldman, Susan; Peeples, Amanda D; Wallace, Brandy

2016-06-01

To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, families, and staff members. Qualitative analyses identified the themes that resulted when examining text describing either structures of care or processes of care in relation to 7 codes associated with stigma. Four themes related to structures of care and stigma were identified, including the physical environment, case mix, staff training, and multilevel settings; five themes related to processes of care and stigma, including dining, independence, respect, privacy, and care provision. For each theme, examples were identified illustrating how structures and processes of care can potentially promote or protect against stigma. In no instance were examples or themes identified that suggested the staff intentionally promoted stigma; on the other hand, there was indication that some structures and processes were intentionally in place to protect against stigma. Perhaps the most important theme is the stigma related to multilevel settings, as it has the potential to reduce individuals' likelihood to seek and accept necessary care. Results suggest specific recommendations to modify care and reduce stigma. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

On the self-stigma of mental illness: stages, disclosure, and strategies for change.

PubMed